ThenosurprisesAct (NSA)

WHEN: The Timeline

- December 2020 Congress passes No Surprise Act in the year-end omnibus spending bill

- January 1, 2022: It is illegal for providers to bill patients for more than the in-network cost-sharing

- January 1, 2023: CMSamends the Fee Guidance For the Independent Dispute Resolution Process

- January 1, 2023: HHSannounces it would not begin enforcement of the good faith estimate (GFE) requirement for uninsured and self-pay individuals However, the GFErequirement continues for facilities and providers (convening providers) that schedule a patient?s visit

WHAT: The Basics:

- Health plans must treat out-of-network services as if they were in-network (except ground ambulance transport)

- The law created a new final-offer arbitration process to determine how much insurers must pay out-of-network providers

- Designed to increase patient choice beyond choosing their facility and principal physician

- Designed to fix a ?market failure?so that patients can understand associated ancillary charges, such as anesthesiologists, assistant surgeons and other providers

- Designed to remove the risk that patients will be surprised by large out-of-network bills, for example when receiving emergency care, elective procedures or being transported by air ambulance