June 01, 2022
Area(s) of Interest: Out of Network Billing
On January 1, 2022, a new federal law, the “No Surprises Act” (NSA), took effect. The NSA was designed to eliminate surprise medical bills for patients enrolled in group health plans and health insurance policies including self-funded/ERISA health benefit plans, who receive: (1) covered non-emergency services by out-of-network providers at in-network facilities, or (2) emergency services by out-of-network providers.
The new law was not intended to supersede state laws on surprise billing and payment and the California Department of Managed Health Care (DMHC) recently issued guidance on the interplay between state and federal law. The California Medical Association (CMA) recently updated its guide – The No Surprises Act: What Physicians Need to Know – to reflect this guidance, eligibility for the NSA Independent Dispute Resolution Process, and other information.
The document – which was published to help physicians understand their rights and obligations under the NSA – is available to members-only.