Introduced in 2019, H.R.3630, or the No Surprises Act, expands restrictions on charging healthcare plan holders out-of-network rates for certain services. The bill also prohibits insurers from billing plan holders more than the median in-network rate for nonemergency services provided by out-of-network providers at in-network facilities.
A September 2021 adjustment to the bill made changes to the rule governing the independent dispute resolution process, which led to concerns from healthcare providers across the country.
The American Hospital Association (AHA) filed a lawsuit challenging the ruling, but recently dismissed that challenge when further revisions to the bill, made in August 2022, rendered the suit moot.
Members of the healthcare community have continued to express concerns over the rule, however.
“No patient should fear receiving a surprise medical bill,” said the AHA in a prepared statement. “[We] strongly supported the No Surprises Act to protect patients from unexpected medical bills and keep them out of the middle of any billing disputes between providers and commercial health insurance companies. Congress enacted the law with a balanced, patient-friendly approach, and it should be implemented that way. We have serious concerns that the August 2022 final rule departs from Congressional intent just as the September 2021 interim final rule did. Hospitals and doctors intend to make our voices heard in the courts very soon about these continued problems.”
