No Surprises Act
The No Surprises Act is a brand new federal legislation that establishes protections from surprising payments for customers with non-public medical health insurance. Take a look at your understanding of the legislation and share your outcomes!
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The No Surprises Act protects you by limiting what you have to pay for certain types of medical bills. Of the types of bills listed below, which one is not subject to No Surprises Act Protections?
Under federal law, the most privately insured patients can be asked to pay for an out-of-network surprise medical bill is
The No Surprises Act prohibits “balance billing” for surprise medical bills. Balance billing by an out-of-network doctor or hospital means
True or false, under federal law, consumers are now protected from balance billing for out-of-network emergency services, including ground and air ambulance transport.
Regulations implementing the No Surprises Act permit health plans to deny coverage for emergency services in which of the following special circumstances:
Consider this scenario: You had cancer surgery at an in-network hospital. Tumor tissue was sent to a laboratory outside of the hospital for analysis. The pathologist who examined the tissue does not participate in your health plan network and bills independently from both the laboratory and the hospital. Do federal surprise medical bill protections apply to the pathologist’s fee?
Consider this scenario: You have surgery at a hospital that participates in your health plan network, but the anesthesiologist is not in your network. Under the No Surprises Act, what is the anesthesiologist permitted to do?
If you get a bill directly from an out-of-network provider for emergency care, how can you tell if that bill is appropriate under the No Surprises Act?
9. Which answer best describes responsibilities that apply to private health plans under the No Surprises Act?
True or false: If a health plan refuses to cover an out-of-network service provided at in an in-network hospital, consumers have the right to appeal, and State Consumer Assistance Programs can help people file appeals.
Under the No Surprises Act, certain out-of-network providers can ask patients in advance to waive their surprise medical bill protections, but the law specifies that certain types of providers are never allowed to ask patients for consent to waive their federal surprise billing rights. Which of the providers below are permitted to ask patients in advance to waive their federal protections?
The No Surprises Act establishes a new independent dispute resolution (IDR) process to determine the amount paid for surprise medical bills when out-of-network providers or facilities and health plans cannot reach agreement on their own. What do patients have to do as part of this IDR process?