RICHMOND, Va. (WRIC) — Soon patients will no longer have to worry about one of the most detested practices in healthcare– surprise medical bills. Congress promised relief is on the way, with The No Surprises Act taking effect Jan. 1, 2022.
Surprise medical billing happens when patients unknowingly receive care that is not covered by their insurance.
Imagine you’re rushed in for surgery to a hospital that is part of your health plan’s network of providers. It may seem all good, but unbeknownst to you, the hospital contracted anesthesiologist is out of network. Now you’re stuck with the tab. These bills can be financially devastating.
“Sometimes this is thousands or even tens of thousands of dollars,” said Nancy Brown CEO of the American Heart Association.
Brown and her group have been fighting for the No Surprises Act.
“One in five patients get a surprise medical bill after surgery,” she said.
The legislation requires insurers and providers to work out how much physicians and hospitals should be paid, first through negotiation. If they can’t agree, it goes to arbitration. Brown says the new law essentially shields families from surprise medical bills.
“The No Surprises Act will take patients out of the middle of payment disputes and protects them,” said Brown.
The Act applies to out-of-network emergency facilities and services, post- stabilization care, even air ambulance transports. Still, some say the legislation still falls short. It does not include ground ambulances. Ambulance rides are a major source of surprise medical bills and consumers generally do not have a choice on which ambulance company to use in emergency situations.
Earlier this month, it was announced a federal advisory committee is being created to address ground ambulance billing practices.
Ground Ambulance and Patient Billing (GAPB) Advisory Committee will deliver recommendations to several federal departments on how to protect consumers from exorbitant charges and balance billing when they use a ground ambulance to access care. The committee will have to issue a report within 180 days of its initial meeting.
Brown says the ground ambulance issue shows the need for Congress to support the rigorous implementation of this new law. She’s encouraging folks to join a national grassroots campaign #StopSurpriseBills by texting SURPRISE to 46839 to press Congress on the issue.