Utah Insurance Department: No Surprises Act Implements New Billing Protections

No Surprises Act No Surprises Act: Protections Against Surprise Billing As of January 1, 2022, consumers have new billing protections when getting emergency care; non-emergency care from out-of-network providers at in-network facilities, including ancillary services such as x-ray, drug, laboratory, or other services; and air ambulance services from out-of-network providers. Through new rules aimed at protecting consumers, out-of-pocket costs will be restricted, and emergency services must continue to be covered without any prior authorization regardless of whether or not a provider or facility is in-network. On December 27, 2020, the Consolidated Appropriations Act, 2021 (CAA) was signed into law, which included the No Surprises Act. The information below summarizes information about the new protections and some examples of how they can protect consumers. Visit https://www.cms.gov/nosurprises opens in a new tab for more information about your rights under this new federal law. Surprise billing happens when a patient receives a balance bill after they receive care from an out-of-network provider or at an out-of-network facility, such as a hospital. It can happen for both emergency and non-emergency care. Sometimes, patients don’t know the provider or facility is out-of-network until they receive the bill. The No Surprises Act is a new federal law intended to offer certain protections related to health care services: If you believe you’ve been wrongly billed by a health care provider, you may file a complaint with the federal government at https://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing opens in a new tab . You may also contact the Utah Insurance Department via email at [emailprotected] or by calling (800) 439-3805 or (801) 957-9280.