Each year seniors receive surprise medical bills ranging from hundreds to tens of thousands of dollars for emergency or out-of-network medical services. Around 1 in 5 emergency visits and 1 in 6 inpatient admissions lead to surprise bills that break seniors’ budgets.
The surprise bills come from balance billing. Balance billing occurs when out-of-network medical providers bill patients for amounts their insurer did not cover. The new bill will finally put an end to unexpected bills from out-of-network providers.
The new legislation has been a top priority for several years for both Democrats and Republicans, but until now a lobbying war between doctors and insurers has prevented anything from passing.
Nancy Brown, CEO of the American Heart Association, said, “Patients nationwide have been waiting for years for legal protection from financially devastating surprise bills, and now relief is in sight.”
What you need to know
The law goes into effect in January of 2022 and will put an end to surprise bills from emergency care, air ambulance, out-of-network hospital care, and care from out-of-network providers. The new fee that patients will pay will be based on in-network care and counted toward their in-network annual deductible. Out-of-network service providers will be required to give patients 72 hours’ notice of their fees. The bill also required a provider-patient bill dispute resolution process for those who are uninsured.
The protections of the bill do not extend to ground ambulance services, but the bill calls for a study to look into ground ambulance billing practices.
Medicare and Medicaid restrict surprise billing practices already, and seniors on Medicare shouldn’t receive unexpected medical bills. Call 1-800-MEDICARE if you receive a bill that you believe is incorrect.