Taking effect January 1, the federal No Surprises Act (NSA) is designed to prevent one of the most common causes of medical-bill sticker shock: an insured patient getting stuck with the entire tab for services by an out-of-network provider they didn’t choose. According to a Department of Health and Human Services report, nearly one in five U.S. hospital visits results in an unexpectedly large bill because a medical provider the patient didn’t select (an anesthesiologist, for example) isn’t part of the patient’s insurance network. The NSA requires insurers to pick up some of those costs and bans hospitals and doctors from charging patients more for out-of-network services than what they’d owe at in-network rates.
The law also provides for independent arbitration if the insurers and providers can’t work out prices in such cases between themselves.