December 23, 2021
About one year ago, Congress enacted and President Trump signed into law the No Surprises Act, providing new federal consumer protections against surprise medical bills. This legislation was included in omnibus legislation funding the federal government for fiscal year 2021 and providing stimulus relief for the COVID-19 pandemic. The new surprise billing protections apply to all commercially insured patients and to almost all out-of-network services where surprise bills are a common occurrence (with the main exception being ground ambulances). Public insurance programs like Medicare, including Medicare Advantage, and Medicaid already include protections from surprise bills. The No Surprises Act will officially take effect on January 1, 2022.
In preparation for the implementation of this new law, U.S. Department of Health and Human Services (HHS), the U.S. Department of Labor, and the U.S. Department of the Treasury ("the Departments") issued three interim final rules (IFCs) on the requirements related to surprise billing. SNMMI responded to the second interim final rule whose requirements:
SNMMI strongly supports the goals of the No Surprises Act, including protecting patients from surprise medical bills, improving the availability of affordable, high-quality, in-network care, and developing a fair and impartial process for resolving provider-insurer payment disputes. Consistent with accomplishing these goals, the Society recommends the Departments provide certain important clarifications and/or modifications to the IFCs, as appropriate, for the following issues:
Our detailed recommendations may be found here. The Centers for Medicare and Medicaid Services' guidance documents on the No Surprises Act may be found here.