December 30th, 2021 – On January 1st, the federal governments new “No Surprises Act” consumer protection law begins to take effect.
The No Surprises Act helps to protect insured people from unexpected charges for claims from out of network providers that they did not choose. Consumers should only be responsible for the in-network cost sharing benefits.
These claims could occur in emergency situations at out of network hospitals, ER’s and air ambulance services, when patients typically have little or no say in where they receive care. They could also include in-network hospitals or surgical centers for services received from an out of network ancillary provider (like an anesthesiologist) who is not in-network and whom the insured did not choose. Under the new law, those claims must be covered as in-network. Balance billing is prohibited and out-of-network providers cannot send patients bills for excess charges.
The No Surprises Act applies to Affordable Care Act (ACA) compliant plans sponsored by employers, purchased through Connect for Health Colorado or directly from insurance carriers for plan years beginning on or after January 1st, 2022.