What You Need to Know About the No Surprises Act

Enacted in late 2020 as part of the Consolidated Appropriations Act of 2021 with an effective date of Jan. 1, 2022, the No Surprises Act (NSA) underscores its primary purpose is to protect patients from surprise medical bills when receiving certain services from – emergency services, non-emergency services from nonparticipating providers at participating facilities, and air ambulance service from nonparticipating providers. (86 Fed. Reg. 36872 (Jul. 13, 2021)).

Essentially, the NSA does three things: (1) limits a patient’s cost-sharing to in-network levels; (2) prohibits balance billing; and (3) establishes an independent dispute resolution process (IDR).