New year, new patient rights!

Great news everyone! On January 1st, 2022, the No Surprises Act went into effect and it provides federal protections for patients from surprise medical bills!  For those that don’t remember, surprise medical bills can happen when someone receives a bill for care they thought should be covered by their insurance.

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Very frequently this happens when patients seek emergency care for things like a heart attack or stroke, only to find out later that the emergency care provided was out-out-of-network. You have no way to know this ahead of time and the last thing you should be worried about in an emergency situation is the cost of your care.

In non-emergency situations you may have done your due diligence and sought care at an in-network hospital, only to receive a surprise bill months (can be more than a year) later because the doctor or other providers associated with your care may not work for the hospital and do not take your insurance

Now, thanks to You’re the Cure advocates patients are protected in these situations!

This law comes into effect after more than three years of advocacy efforts from You’re the Cure advocates, staff and volunteers across the country. YTC advocates contacted and met with their lawmakers and agency officials, they shared their personal stories on how surprise medical bills negatively impacted them with media outlets across the country through Op-Ed’s and LTE’s and recorded ads urging Congress and the administration to take immediate action to protect patients. In short, YTC advocates used every tool at their disposal to finally put an end to surprise medical bills.  While it was tough sledding, thanks to advocates like you we achieved our goal and the No Surprises Act will protect millions of patients per year from falling victim to this predatory billing practice.

The No Surprises Act is another step forward in YTC’s and the American Heart Association’s efforts to ensure everyone in America has equitable access to quality, affordable health care and we are so grateful for all you did to make this a reality!

So what’s new?

Beginning this month, consumers with group or individual health plans are protected from receiving surprise medical bills for most emergency services, non-emergency services from out-of-network providers at in-network facilities, and services from out-of-network air ambulance providers. Specifically, this law will…

  • Ban surprise bills for most emergency services even if you get them out-of-network and without prior authorization.
  • Ban out-of-network cost-sharing for most emergency and some non-emergency services.
  • Ban out-of-network charges for certain services like anesthesiology or radiology furnished by out-of-network providers as part of a patients’ visit to an in-network facility.
  • Require that health care providers and facilities give you an easy-to-understand notice explaining your new protections and who to contact if you have concerns.
  • Require health care providers to seek patient consent to waive surprise medical billing protections.

For a more detailed information about the new law, we encourage you to refer to CMS resources about the No Surprises Act as well as this great fact sheet about your new rights.

 

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