No Surprise Act

The No Surprise Act went into effect on January 1, 2022

The following information gives a summary of the protections this law provides to patients.

NSA NOTICE AND GOOD FAITH ESTIMATE PROVISIONS

Two of the primary purposes of the No Surprises Act are:

To prohibit an out-of-network provider from charging, without that patient’s prior agreement, the out-of-network provider’s private (i.e., out-of-network) rate when the patient receives treatment at that patient’s otherwise-in-network healthcare facility. Prior to the NSA, such patients often received unexpected and very large bills from out-of-network providers who provided services to the patient without the patient’s agreement to pay these out-of-network providers at out-of-network rates;

To require both healthcare facilities and individual healthcare providers to furnish uninsured/self-pay patients with a Good Faith Estimate (GFE) of the likely cost of a proposed treatment prior to the uninsured/self-pay patient’s receiving that service. Under the NSA, the uninsured/self-pay patient can decide whether to proceed with treatment based on the Good Faith Estimate of its cost. If the uninsured/self-pay patient agrees to proceed based on the Good Faith cost estimate, the patient has legal recourse if the actual cost of the treatment varies significantly, and without acceptable justification, from the GFE for that treatment.

For further information on the NSA and the protections it offers for patients, please go to https://www.cms.gov/nosurprises. Please talk with your provider if you have any questions.