The Consolidated Appropriations Act of 2021 established several new requirements for providers, facilities, and providers of air ambulance services to protect consumers from surprise medical bills. These requirements are collectively referred to as “No Surprises” rules. Among other things, these include prohibiting balance billing in certain circumstances and requiring disclosure about balance billing protections, requiring transparency around health care costs, providing consumer protections related to continuity of care, and establishing requirements related to provider directories.

These requirements generally apply to items and services provided to consumers enrolled in group health plans, group or individual health insurance coverage, and Federal Employees Health Benefits plans. The requirements for transparency of health care costs and the requirements related to the patient-provider dispute resolution process also apply to uninsured consumers.

These requirements don’t apply to people with coverage through programs like Medicare, Medicaid, Indian Health Services, Veterans Affairs Health Care, or TRICARE. These programs have other protections against high medical bills.

The Department of Health and Human Services (HHS), in coordination with the Department of the Treasury, Department of Labor and the Office of Personnel Management, launched a website focused primarily on providing general information about No Surprises Act provisions. This website currently includes standard notice and consent documents, and a model disclosure form. HHS intends to post additional information to this website over the next several months.

Website: https://www.cms.gov/nosurprises/consumers.

Phone Number for information or complaints:  1-800-985-3059

As part of the new requirement, Boulder City Hospital and Boulder City Primary Care will begin issuing the “Surprise Billing Protection Form” to patients who are out-of-network or who have become out-of-network.  You aren’t required to sign the form and can choose to get care from a provider or facility in your health plan’s network. You can do this by contacting your health plan.

As a reference, we have included as a download, the patient handout called “Your Rights and Protections Against Surprise Medical Bills”