New survey says: The No Surprises Act is working

Published January 30, 2024

A new survey by BCBSA and AHIP shows that the No Surprises Act (NSA) prevented more than 10 million surprise bills in the first nine months of 2023 — continuing to protect millions of Americans from crippling medical bills each year.

What is the No Surprises Act?

Taking effect Jan. 1, 2022, the NSA bans billing patients for surprise, or so-called “balance” bills, for a visit to an emergency department or other in-network facility by an out-of-network provider a patient did not, or could not, choose. Because of the NSA, there is now an Independent Dispute Resolution (IDR) process — a negotiating tool intended for use in limited circumstances — for providers and health insurers to resolve disagreements about the bill without involving the patient. It also gives patients the right to file a dispute when they are not using insurance and are paying the provider directly.

The Role of IDR

The new analysis found that nearly 80% of eligible claims involving insurers were resolved without the use of the IDR process with providers accepting the initial payment offered by health insurance providers, confirming that the vast majority of these payments are found to be reasonable. However, the AHIP and BCBSA research also confirmed a growing and troubling trend — the skyrocketing use of the IDR process.

“Getting a bill is never fun,” said David Merritt, SVP of policy and advocacy for BCBSA. “Getting a surprise bill is awful. I'm proud to see that the No Surprises Act is doing what it’s supposed to — protecting millions of families from unexpected financial hits and the peace of mind that a surprise medical bill won’t cost them their next paycheck.”

Provider Networks Grow

The study also found that two-thirds of health insurance providers reported their provider networks have increased since the NSA became law, with none reporting an overall reduction in participating providers. This growth comes despite concerns that doctors would leave networks.

The BCBSA/AHIP joint survey follows the same framework as two previous reports issued in May 2022 and updated with new findings in November 2022.

The Blue Cross and Blue Shield Association is an association of independently owned and operated Blue Cross and Blue Shield companies.