Surprise Billing

About Surprise Billing

The No Surprises Act protects people covered under group and individual health plans 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 service providers. While California hospitals are already leaders in ensuring patients understand their out-of-pocket costs and offering clear, written discount and charity care policies to help certain patients, new AHA guidelines(Login required) are a way for hospitals to reinforce their commitment.

No Surprises Act — Hospital Contracting and Compliance Implications

The No Surprises Act was signed into law on Dec. 27, 2020, as part of the Consolidated Appropriations Act of 2021. It addresses surprise medical billing for federally-regulated plans and in states without surprise billing laws. Most sections of the legislation are effective Jan. 1, 2022. As the name implies, this Act prohibits patients from getting surprise bills in certain out-of-network situations. The Departments of Health & Human Services, Treasury and Labor will issue regulations and guidance to implement numerous provisions.