No more surprise bills: new protections for patients

Published February 10, 2022

A new law called the No Surprises Act went into effect on January 1st, 2022. It protects patients from receiving surprise medical bills. Blue Cross and Blue Shield health plans stand behind these bipartisan-backed protections. Here’s what you need to know.

What is the No Surprises Act?

The No Surprises Act includes provisions to protect patients from having to pay an unexpected amount for facility-based services provided by certain out-of-network health care providers. These providers could include a doctor a patient didn't choose themselves, an air ambulance or even the facility itself for emergency services. Patients aren’t always able to choose an in-network provider. The idea behind the No Surprises Act is that they shouldn’t be penalized for it.

“This law protects patients from unexpected and costly bills, while also taking meaningful steps to build a more affordable, transparent health care system. For any questions, you can call the customer service number on the back of your member ID card or on your plan's website,” said Sean Robbins, Executive Vice President, External Affairs, Blue Cross Blue Shield Association.”

What’s a surprise bill?

A surprise bill is an unexpected bill patients receive for the balance owed to an out-of-network facility or health care provider for certain facility-based services. The balance is what’s owed after insurance has paid their part of the claim.

Patients can usually choose an in-network provider. But there may be no time to choose in an emergency or a patient may not know about other providers who treat them while they're admitted. For example, a patient could be taken to an in-network hospital but treated by an out-of-network anesthesiologist. That doctor could, before the law passed, bill the patient for the difference between what insurance typically pays and what they charge.

How does the No Surprises Act fix that?

Out-of-network emergency and some other facility-based health care providers can no longer “balance bill” a patient. Those providers will have to negotiate a rate with the patient’s insurer or work with a third party to come to a decision.

Will the No Surprises Act make health care more affordable?

Under the law, patients will no longer receive surprise medical bills, which have sometimes amounted to thousands of dollars. The Act may also help rein in unreasonable prices, making health care more affordable for everyone.

It’s no secret that the growing cost of health care in the United States is unsustainable. Blue Cross and Blue Shield plans are making important strides to slow the growth. Those include paying doctors for the quality, not the quantity, of care they provide; helping members maintain their health and wellness; and ensuring patients receive the care they need in the most appropriate setting.

Questions about an experience with surprise billing? Contact your Blue Cross and Blue Shield health plan at the number on the back of your member ID. Read more about how BCBS companies are promoting sustainably affordable, high-quality health care.