By Cassie Miller | Pennsylvania Capital-Star
Credit: PA Internet News Service
Gov. Tom Wolf and representatives from the Pennsylvania Insurance Department (PID) gathered Monday in Philadelphia to highlight a federal law scheduled to take effect on Jan. 1, 2022 that would curb surprise medical bills for many Americans.
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The No Surprises Act was passed by Congress last December as part of the Consolidated Appropriations Act to protect patients and address surprise medical bills by requiring that health care providers and facilities provide patients with a “good faith estimate” for care.
According to PID, surprise billing protections apply if you get your coverage through:
- Your employer (including a federal, state, or local government)
- The state-based Marketplace, Pennie
- Directly through an individual market health insurance company.
“A patient who has carefully researched and selected an in-network facility and provider or is seeking care because of an emergency should not be stuck with out-of-network costs and billing when they had little or no choice regarding providers that may, in the end, be out-of-network,” Wolf said in a statement Monday. “The Wolf administration has been committed to protecting consumers from balance billing, and the implementation of the No Surprises Act is a major step toward ending unexpected, upsetting and many times financially devastating medical bills.”
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Additionally, the No Surprises Act will protect patients from surprise bills by requiring that emergency services are billed as in-network, without needing prior approval, the Wolf administration confirmed Monday. “Certain non-emergency services at an in-network facility provided by out-of-network ancillary providers are also covered as in-network,” the statement read, but it did not specify which non-emergency services were covered.
On Monday, Wolf signed an executive order designating PID as the state agency to lead implementation of the No Surprises Act in Pennsylvania.
“The Insurance Department has received numerous complaints about surprise bills over the past few years,” Insurance Commissioner Jessica Altman said Monday. “Our medical system is complicated enough. The primary concern following major medical procedures should be recovery, not worry over medical billing. My department stands ready to implement this new legislation and protect consumers who act in good faith.”
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Pennsylvanians who receive surprise medical bills for services beginning Jan. 1, 2022 are encouraged to reach out to the Pennsylvania Insurance Department with questions or to file a complaint.
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