The No Surprises Act (NSA), adopted as part of the 2021 Consolidated Appropriations Act, builds on parts of the ACA by creating comprehensive patient protections against surprise medical bills for emergency services, air ambulances and certain nonemergency services. Plan administrators should prepare to post on a public website, and on each applicable EOB, information, written in plain language, about balance-billing restrictions, applicable state law protections, the federal protections, and contact information for an appropriate state and federal agency in the event a provider or facility violates the balance-billing restrictions. Until guidance is issued, plans and insurers are expected to implement these requirements for the first plan year starting in 2022 using a good faith, reasonable interpretation. Plans and insurers may, but are not required to, use the model notice to meet these disclosure requirements.
Plan administrators should work with their TPA or insurer to determine how they will satisfy these requirements.
Until implementation guidance is available, many questions remain, including: what qualifies as the plan’s public website; what does publicly available mean; what state information is required of self-insured plans. We’ll keep you informed as more guidance becomes available.