The Consolidated Appropriations Act, 2021, signed by President Trump on December 27, 2020, included within its over 5,900 pages the controversial and long-debated No Surprises Act (the Act), addressing surprise medical bills. The Act seeks to protect patients from unexpected medical bills for out-of-network services they receive, and also establishes an arbitration system for resolving billing disputes between out-of-network health care providers and payers. The Act takes effect on January 1, 2022, and it is anticipated that regulations will be adopted to clarify a number of provisions in the Act prior to that time. New Jersey health care providers and insurers are already subject to the Out-of-Network Consumer Protection, Transparency, Cost Containment and Accountability Act (the New Jersey Act), which was passed by the state legislature and signed by Governor Murphy in 2018, and is similar in several significant aspects to the federal Act. This alert will review the patient protection and payer-provider billing dispute procedures of the new federal Act, compare them to the New Jersey Act and discuss how providers have fared under the arbitration process established by the New Jersey Act.
Read moreThe New Federal Out-of-Network Statute
As part of the recently enacted Consolidated Appropriations Act, 2021 (the "Appropriations Act"), the federal government did not only provide relief to stem the effects of the COVID-19 pandemic, but it also adopted the No Surprises Act.
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