First rules implementing surprise medical billing law issued

On July 1, 2021, the U.S. Departments of Labor, Treasury, and Health and Human Services (HHS) issued the first rules implementing the No Surprises Act, which prohibits health care providers from billing patients more than they would be paid for in-network services in emergencies or other circumstances when out-of-network physicians are used. The interim final rule, which is the first of several expected this year, focuses on how rates will be calculated to determine how much out-of-network providers will be paid.

The rules prohibit surprise billing for emergency services, and emergency services must be treated on an in-network basis without prior authorization requirements, regardless of where the services are provided.

Out-of-network charges for ancillary care (such as anesthesiologists or assistant surgeons) at an in-network facility are prohibited in all circumstances. 

Source: https://www.jdsupra.com/legalnews/first-rules-implementing-surprise-5548535/