While health care headlines understandably continue to lead with all things COVID, there was a significant national piece of legislation that went into effect at the beginning of the year that Regence BlueCross BlueShield wants to ensure we’ve highlighted for you and your employees.
No Surprise Act
Americans now have more financial protections from surprise medical bills thanks to a new federal law that went into effect January 1. This is great news for patients, especially in pandemic times of high stress and potentially serious health episodes.
As part of the No Surprises Act:
- Patients still have to pay in-network copays, deductibles, and other cost-sharing as part of their health insurance.
- But any additional out-of-network bills are now prohibited for:
- Emergency care in a hospital ER, a freestanding ER or urgent care center.
- Elective care at an in-network hospital or surgery center, but where doctors — notably anesthesiologists, pathologists, radiologists, and assistant surgeons — may be out-of-network.
- And air ambulances.
Put another way, patients are now protected from most unexpected medical charges from out-of-network doctors and hospitals. Currently, as many as one in five emergency room visits and one in six in-network hospitalizations can include at least one surprise out-of-network bill.
This is a new law, so inevitably it will take time for the health care system to correctly adopt it. Regence encourages patients to seek out care from in-network providers; be sure to ask before receiving care if they are in your insurance network to ensure you’re getting the most affordable care under your plan. Patients with complaints can visit www.cms.gov/nosurprises or call 1-800-985-3059.
Contributed by: Vince Porter | Director of Public Affairs and Government Relations Regence BlueCross BlueShield of Oregon