New Ban on Surprise Medical Bills
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If you have a medical emergency, you will no longer need to worry about a large bill from a doctor you did not choose.
For years, millions of Americans with medical emergencies could receive another nasty surprise: a bill from a doctor they did not choose and who did not accept their insurance. A law that goes into effect Saturday will make many such bills illegal.
The change is the result of bipartisan legislation passed during the Trump administration and fine-tuned by the Biden administration. It is a major new consumer protection, covering nearly all emergency medical services, and most routine care.
"I think this is so pro-consumer, it's so pro-patient - and its effect will eventually be felt by literally everybody who interacts with a health care system," said Senator Bill Cassidy, a Republican from Louisiana, who was part of a bipartisan group of lawmakers who wrote the bill. He said he counted the bill as among his top achievements as a lawmaker.
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If you are having a medical emergency and go to an urgent care center or emergency room, you can't be charged more than the cost sharing you are accustomed to for in-network services. This is where the law's protections are the simplest and the most clear for people with health insurance.
You will still be responsible for things like a deductible or a co-payment. But once patients make that normal payment, they should expect no more bills.
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Several studies found that around 20 percent of U.S. patients who had emergency care were treated by someone outside of their insurance network, including emergency room doctors, radiologists or laboratories. Any of those providers could send patients an extra bill after the fact, and some medical groups did so routinely. Such bills are now illegal.
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For scheduled services, like knee operations, C-sections or colonoscopies, it's important you choose a facility and a main doctor that is in your insurance plan's network. If you do that, the law bars anyone else who treats you from sending you a surprise bill. This also addresses a large problem. Surprise bills from anesthesiologists, radiologists, pathologists, assistant surgeons and laboratories were common before.
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