No Surprises Act
E851378
The No Surprises Act is a U.S. federal law that protects patients from unexpected out-of-network medical bills and limits balance billing in many emergency and non-emergency care situations.
Statements (48)
| Predicate | Object |
|---|---|
| instanceOf |
United States federal law
ⓘ
health care consumer protection law ⓘ |
| aimsTo |
reduce medical debt caused by unexpected bills
ⓘ
shift payment disputes from patients to insurers and providers ⓘ |
| appliesTo |
certain non-emergency services at in-network facilities
ⓘ
emergency services ⓘ group health plans ⓘ individual health insurance coverage ⓘ most employer-sponsored health plans ⓘ patients with private health insurance ⓘ |
| category |
health insurance regulation
ⓘ
patient financial protection ⓘ |
| containsProvision |
air ambulance surprise billing protections
ⓘ
good faith estimate for uninsured and self-pay individuals ⓘ patient-provider dispute resolution for uninsured and self-pay individuals ⓘ |
| country |
United States of America
ⓘ
surface form:
United States
|
| dateEnacted | 2020-12-27 ⓘ |
| doesNotApplyTo |
Medicaid billing rules
ⓘ
traditional Medicare billing rules ⓘ |
| effectiveDate | 2022-01-01 ⓘ |
| enforcedBy |
Centers for Medicare & Medicaid Services
NERFINISHED
ⓘ
state insurance regulators ⓘ |
| establishes | independent dispute resolution process for payment disputes ⓘ |
| exempts |
short-term limited duration insurance
ⓘ
stand-alone dental plans ⓘ stand-alone vision plans ⓘ |
| implementedBy |
U.S. Department of Health and Human Services
NERFINISHED
ⓘ
U.S. Department of Labor NERFINISHED ⓘ U.S. Department of the Treasury NERFINISHED ⓘ |
| jurisdiction |
United States government
ⓘ
surface form:
United States federal government
|
| partOf | Consolidated Appropriations Act, 2021 NERFINISHED ⓘ |
| prohibits |
balance billing for certain non-emergency services at in-network facilities
ⓘ
balance billing for emergency services in many situations ⓘ most surprise out-of-network bills for emergency services ⓘ |
| protects |
insured patients from surprise out-of-network bills at in-network facilities in many cases
ⓘ
insured patients from surprise out-of-network emergency bills ⓘ |
| purpose |
increase price transparency in health care
ⓘ
limit balance billing ⓘ protect patients from unexpected out-of-network medical bills ⓘ |
| regulates |
air ambulance billing
ⓘ
balance billing ⓘ out-of-network billing practices ⓘ |
| requires |
advance notice and consent for certain out-of-network services
ⓘ
disclosure of patient protections against surprise billing ⓘ good faith estimates of charges for uninsured and self-pay patients ⓘ provider-payer independent dispute resolution process ⓘ |
| scope | commercial health insurance markets ⓘ |
| signedIntoLawBy | Donald Trump NERFINISHED ⓘ |
Referenced by (1)
Full triples — surface form annotated when it differs from this entity's canonical label.