New Law to Ban Many Surprise Medical Bills

Woman with surprise medical bill
Photo by Antonio Guillem / Shutterstock.com

Patients fed up with receiving surprise medical bills might get some relief beginning in 2022.

The pandemic stimulus and federal funding package that President Donald J. Trump signed into law this week contains a law — the No Surprises Act — that generally bans the practice of balance billing without a patient’s advance consent.

This costly maneuver occurs when an out-of-network medical provider treats you without you realizing that the provider is not in your insurance company’s network.

For example, an out-of-network doctor may treat you in an emergency situation. It’s even possible that an out-of-network physician or laboratory would provide care for you at an in-network hospital.

Currently, insurance companies can bill patients for the difference between the provider’s charge and the amount allowed by the patient’s insurer.

For example, such a balance-billing process might be used if the provider’s charge is $100, but your insurance company’s allowed amount is just $70. In that case, you would owe the $30 necessary to pay the difference between the two amounts.

However, this practice effectively will become illegal on Jan. 1, 2022. Specifically, out-of-network providers generally will not be able to balance-bill you unless they notify you that they are out of network and give you an estimate of charges 72 hours before treating you, and you consent to receiving that out-of-network care.

The new law does not cover all medical services. NPR reports that the bill does not extend to ground ambulance services, for example.

However, Zack Cooper, an associate professor of public health and economics at Yale University who studies health care pricing, still praised the new law. He tells NPR:

“No law is perfect. But it fundamentally protects patients from being balance-billed. That’s a remarkable achievement.”

The new law offers other protections. Consumer Reports says it guarantees that all emergency room medical care will be billed to consumers at the “in-network” rate. That is true even if the hospital or individual health care provider is not in the patient’s insurance network.

The law also mandates that insurers and health care providers work together to determine payment amounts. In the past, patients often have had to negotiate payment of surprise medical bills on their own.

Consumer Reports notes that the new law applies to most types of health insurance, including those offered through the Affordable Care Act marketplace. However, the law does not apply to short-term health insurance plans that typically cover people for six months or less.

For more ways to contain your medical costs, check out “5 Ways Anyone Can Save on Out-of-Pocket Health Care Costs.”

Disclosure: The information you read here is always objective. However, we sometimes receive compensation when you click links within our stories.

Read Next
12 Tech Gadgets That Make Daily Life Easier
12 Tech Gadgets That Make Daily Life Easier

These products on Amazon will ease worries and simplify your routine.

Half of All Retirees Say They Fear This
Half of All Retirees Say They Fear This

Chances are good that you share this fear. Here’s a way to overcome it.

These Are the 3 Best Used Cars You Can Buy
These Are the 3 Best Used Cars You Can Buy

These vehicles boast reliability, safety and long-lasting value.

Retiree Households Lose $111,000 to This Social Security Misstep
Retiree Households Lose $111,000 to This Social Security Misstep

A study finds 96% of retirees make this mistake when claiming Social Security benefits.

7 Surprising Advantages of Downsizing as a Retiree
7 Surprising Advantages of Downsizing as a Retiree

Downsizing your home offers many benefits, including some you may not have anticipated.

View this page without ads

Help us produce more money-saving articles and videos by subscribing to a membership.

Get Started

Most Popular
7 Kirkland Signature Items to Avoid at Costco
7 Kirkland Signature Items to Avoid at Costco

Even if it seems you save a bundle buying Costco’s Kirkland Signature brand products, they may not be the bargain they appear to be.

How to Buy Gas At Costco Without a Membership
How to Buy Gas At Costco Without a Membership

The warehouse club often has some of the cheapest gas in town. Here’s how you can get it as a nonmember.

10 Things to Stop Buying If You Want a Clutter-Free Home
10 Things to Stop Buying If You Want a Clutter-Free Home

If you like to keep things simple, avoid these purchases.

If You Find This Thrift Shopping, Buy It
If You Find This Thrift Shopping, Buy It

Vacuums from this brand can last a half-century, if not longer — and they’re hot on the resale market.

A Simple Way to Silence Robocalls Today
A Simple Way to Silence Robocalls Today

A few steps can keep your phone from ringing when a spammer calls.

This Company Makes the Best Tires in America
This Company Makes the Best Tires in America

Driver satisfaction with tires is at an all-time high, but one brand stands out.

This Health Issue Can Hint at Dementia Years in Advance
This Health Issue Can Hint at Dementia Years in Advance

One type of pain is especially associated with cognitive decline.

Can I Switch to Spousal Social Security Benefits When My Ex Dies?
Can I Switch to Spousal Social Security Benefits When My Ex Dies?

Knowing when to claim can help you maximize benefits.

Medicare Will Not Cover These 6 Medical Costs
Medicare Will Not Cover These 6 Medical Costs

Don’t let these health care expenses catch you off guard in retirement.

8 Things You Should Always Buy on Amazon
8 Things You Should Always Buy on Amazon

The giant retailer shines when it comes to these things, from basics to hard-to-find specialty goods.

5 Ways to Get Amazon Prime for Free
5 Ways to Get Amazon Prime for Free

Hesitant to drop $119 a year on an Amazon Prime membership? Here’s how to get it for free.

12 Deep Discounts Available on Amazon This Friday
12 Deep Discounts Available on Amazon This Friday

These items are steeply discounted — but the deals won’t last long.

5 Ways to Fill Your Pantry With Free Food
5 Ways to Fill Your Pantry With Free Food

Anyone can take advantage of these resources.

3 Ways to Get Microsoft Office for Free
3 Ways to Get Microsoft Office for Free

With a little ingenuity, you can cut Office costs to zero.

6 Reasons You Should Stop Hiding Cash at Home
6 Reasons You Should Stop Hiding Cash at Home

Stashing money around the house is anything but harmless.

5 States With the Worst Health Care for Retirees
5 States With the Worst Health Care for Retirees

All of these states are located in the same region of the nation.

36 Things That Will Be Obsolete Soon
36 Things That Will Be Obsolete Soon

The writing is on the wall for dozens of things we have grown up with.

5 Products You Should Never Buy Generic
5 Products You Should Never Buy Generic

Sometimes the brand-name version is clearly superior.

This Cellphone Carrier Has the Worst Network Quality, Customers Say
This Cellphone Carrier Has the Worst Network Quality, Customers Say

One major wireless provider stands out for the least reliable call, messaging and data services.

View More Articles

View this page without ads

Help us produce more money-saving articles and videos by subscribing to a membership.

Get Started

Add a Comment

Our Policy: We welcome relevant and respectful comments in order to foster healthy and informative discussions. All other comments may be removed. Comments with links are automatically held for moderation.