Don’t be surprised by the ‘No Surprises Act’

No Surprises Act

The “No Surprises Act,” which goes into effect January 1, 2022, is substantive federal legislation designed to protect patients from unexpected or “surprise” medical bills and to provide consumers with greater access to information as a way to improve price transparency. Not surprisingly, the Act imposes significant new requirements on providers and group health plans in order to accomplish these goals.

During this complimentary webinar, McAfee & Taft employee benefits attorneys Brandon Long and Lake Moore will assist employers and sponsors of group health plans in understanding the No Surprises Act’s major provisions and new requirements related to:

  • Advanced explanations of benefits (EOBs), which must be provided to plan participants in certain circumstances
  • ID card transparency, which requires disclosure of deductible and out-of-pocket maximums on health plan ID cards
  • Website price comparison tools, which must be maintained so that participants can shop and compare providers and pricing
  • Provider Directory Database, which must provide specific, updated information about healthcare providers
  • EOB disclosures regarding balance billing prohibitions, which require EOBs to contain certain information regarding the surprise billing rules
  • Patient protections that prevent surprise medical bills, which most often occur when a patient receives services from out-of-network providers at in-network facilities
  • Advance continuity-of-care disclosures, which are required when a provider goes out of network while a patient is still under their care