HHS Announces Rule to Protect Consumers from Surprise Medical Bills
Federal officials announced on July 1 an interim final rule that aims to protect consumers from surprise medical billing and balance billing. "No patient should forgo care for fear of surprise billing," said Health and Human Services (HHS) Secretary Xavier Becerra. "Health insurance should offer patients peace of mind that they won't be saddled with unexpected costs." Surprise billing occurs when patients unknowingly receive care from providers who are outside their health plan's network; this can happen with both emergency and non-emergency care. Balance billing is when a provider charges a patient the balance of what their insurance does not cover. The practice is prohibited by both Medicare and Medicaid, and the new rule would include similar protections for individuals covered by employer-sponsored and commercial health plans. The rule prohibits surprise billing for emergency services, bans high out-of-network cost-sharing for emergency and non-emergency services, prohibits out-of-network charges for ancillary care at an in-network facility, and bans other out-of-network charges without advance notice. Surprise medical billing can have devastating financial effects for patients and their families, with two-thirds of all bankruptcies files in the United States linked to medical expenses. The new regulations will take effect for health care providers and facilities on Jan. 1, 2022. For group health plans, health insurance issuers, and Federal Employees Health Benefits Program carriers, the provisions will take effect for plan, policy, or contract years beginning on or after Jan. 1, 2022.
Read more on HHS News Release.