Patients worried about getting hit with an unexpected bill after emergency care gained a layer of protection this month from a new federal law. Here’s a breakdown of the No Surprises Act, and what it means for patients.
It also offers protection in care that isn’t an emergency when people are treated at in-network hospitals by a provider outside their network. That can include radiology, lab work or care from an anesthesiologist.Many states already regulate surprise medical bills. The federal law supplements those measures.The No Surprises Act beefs up protection against insurer claim rejections for emergency visits.
They have denied coverage if they deem patient visits to be not emergencies. Doctors worry this practice will deter patients from seeking life-saving care when they need it. That means insurers should not deny a claim to a patient who rushed to the ER thinking she was having a heart attack but ultimately was diagnosed with heart burn.In some cases that aren’t emergencies, a doctor outside the network may ask a patient to waive their protections from the law. In exchange, they will provide an estimate of what the care will cost.Patients have to sign this waiver before the care.
“This isn’t necessarily going to protect people from big bills, but it is going to protect them from undiscounted bills,” said Karen Pollitz, a senior fellow at the Kaiser Family Foundation, which studies health care issues.
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