Source: Health Policy Institute of Ohio
The Biden administration has put the final touches on consumer protections against so-called “surprise” medical bills (Source: “Ban on ‘Surprise’ Medical Bills on Track for January 1 Rollout,” Associated Press, September 30, 2021).
The rules released on September 30 spelled out for the first time a key part of the new system: a behind-the-scenes dispute resolution process that hospitals, doctors, and insurers will use to haggle over fees, without dragging patients into it.
Patients will no longer have to worry about getting a huge bill following a medical crisis if the closest hospital emergency room happened to have been outside their insurance plan’s provider network. They’ll also be protected from unexpected charges if an out-of-network clinician takes part in a surgery or procedure conducted at an in-network hospital. In such situations, patients will be liable only for their in-network cost-sharing amount.
The ban on unexpected charges to insured patients is on track to take effect Saturday, January 1, 2022, officials said.