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What the No Surprises Act Means for Patients, Providers, and Payers

First few Article Sentences

At the closing of 2020, former President Donald Trump signed a $1.4 trillion year-end spending deal known as the No Surprises Act as part of the Consolidated Appropriations Act of 2021 to address surprise medical billing at the federal level. The law goes into effect on January 1, 2022.

On July 1, 2021, the Department of Health and Human Services (HHS), Department of the Treasury (collectively, the Departments), along with the Office of Personnel Management (OPM) released an interim final rule with comment period (IFC), titled Requirements Related to Surprise Billing; Part I.

This IFC implements many of the No Surprises Act’s requirements for group health plans, health insurance issuers, carriers under the Federal Employees Health Benefits (FEHB) Program, health care providers and facilities, and air ambulance service providers.

The regulations issued will take effect for health care providers and facilities on January 1, 2022. For group health plans, health insurance issuers, and FEHB Program carriers, the provisions will take effect for plan, policy, or contract years beginning on or after January 1, 2022.

The Congressional Budget Office estimates that the No Surprises Act will result in direct savings for consumers through reduction of commercial insurance premiums by 0.5% to 1%, while simultaneously lowering payments to some providers.

Mori, Mandy

Stark, Denise

Moss Adams

Law, Provider Reimbursement

August 10, 2021

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