No Surprises Act Info

Disputing Out-of-Network Payments Using the No Surprises Act

 

Preparing for the No Surprises Act

On Dec. 27, 2020, the No Surprises Act (NSA) was signed into law as part of the Consolidated Appropriations Act of 2021.  These provisions were intended to address unexpected gaps in insurance coverage that result in “surprise medical bills” when patients unknowingly obtain medical services from physicians and other providers outside their health insurance network.

Because the No Surprises Act, which takes effect on Jan. 1, 2022, imposes limits and confers some rights on physicians caring for patients in these situations, it is important for physicians to understand how the law will affect them.

Read the AMA’s summary of the NSA (PDF).

Implementation of the No Surprises Act

Please see the Implementation of the No Surprises Act Overview for additional information on the Interim final rule.

You can access the AMA Took Kit here.

Additional Links Below

Reconciling New York and federal law differences: Insurance Circular Letter No. 10 (2021): The No Surprises Act, Independent Dispute Resolution Process, and Disclosure of Protections from Balance Billing | Department of Financial Services (ny.gov)

NSA and continuity of care Insurance Circular Letter No. 11 (2021): | Department of Financial Services (ny.gov)

IDR for Provider Directory Misinformation – Insurance Circular Letter No. 12 (2021): Provider Directory and Health Insurance Identification Card Requirements under the No Surprises Act and State Law | Department of Financial Services (ny.gov)

NY-specific Required Physician Disclosure Form – Model Provider Disc_Balance_Bill_Protections_20211217.docx (live.com)