New Ban on Surprise Medical Bills Just Went Into Effect

A new ban on surprise medical bills went into effect on Saturday, The New York Times reports.

After years of news reports of Americans with medical emergencies receiving surprise bills from doctors they did not choose and who did not accept their medical insurance, Congress passed a bill during the Trump administration to ban the practice with bipartisan support. The legislation was later fine-tuned by the Biden administration.

“I think this is so pro-consumer, it’s so pro-patient — and its effect will eventually be felt by literally everybody who interacts with a health care system,” Republican Louisiana Sen. Bill Cassidy said.

“This is such an important consumer victory because it is going to protect consumers from an egregious and pervasive billing practice that has just grown over the years,” added Patricia Kelmar, the health care campaigns director at the consumer advocacy group U.S. PIRG.

How it works:

Emergency medical bills can add up even for people who are insured and patients with high deductibles could face huge out-of-pocket costs.

The new law will eliminate the risk that a doctor or hospital that does not accept a patient’s insurance will hit them with an extra bill.

Under the law, emergency rooms and urgent care centers cannot charge patients more than the cost sharing they would be charged for in-network services. That means patients will only be on the hook for their deductible or co-pay but no additional bills.

Multiple studies have found that 20% of patients sought emergency care out of their insurance network.

One exception:

The law includes an exception for ambulance services.

The law does not ban ambulance companies from billing patients directly, though it does include protections for surprise bills from air ambulances.

Congress has established a commission to study how to regulate ambulance billing.

Eleven states currently prevent ambulances from sending out-of-network medical bills.

In other states, about half of people who require an ambulance are typically hit with a surprise bill.


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