What's ahead with the "No Surprises Act"

In this article from the Governance Institute by Waller's Stacy Hooper, Nathan Kottkamp and Nathan Lykins, the authors discuss the "No Surprises Act" and what lies ahead, including the anticipated ramifications of the Act in practice and issues to consider as the regulations are developed. 

The No Surprises Act, which was signed into law in December 2020 as part of the Consolidated Appropriations Act, 2021, intended to address the problem of balance billing patients. Balance billing creates problems for patients who cannot pay exorbitant medical bills and for payers and providers. 

The Act is the first comprehensive effort at the federal level, and it required federal agencies to publish regulations. The Act makes it clear that healthcare providers, insurers, and self-insured health plan sponsors should be ready to address related budgetary, operational and administrative changes in the near future. The changes include: 

• Out-of-Network services and patient financial responsibility
• Provider reimbursement rates
• Various other patient protections

To learn more about the Act and what it means for payers and providers, read the full article published by the Governance Institute here.