On January 1, 2022, the surprise billing provisions of the Consolidated Appropriations Act, 2021 - commonly referred to as the No Surprises Act - go into effect. Surprise billing occurs when a privately insured individual receives an unexpected bill either in an emergency situation or when a service in an in-network facility is provided by an out-of-network provider. Key among the No Surprises Act provisions is removing the patient from disputes between payers and providers. This brief provides background information on surprise billing, describes some of the consumer protections in the No Surprises Act that will be available to those who have not been covered by previous state laws, and sketches out the process for resolving claims when there is a dispute between providers and payers.
Related Products: