Changes Designed to Stop “Surprise Billing” Coming Next Year

Changes Designed to Stop “Surprise Billing” Coming Next Year

Last year TSCL supported legislation to stop “surprise billing,” which happened when patients were billed for medical procedures they had thought were covered by their health care insurance, but actually were not.

Congress passed the legislation and it will go into effect next year.  While surprise billing happened more frequently to those who were covered by employer-provided insurance, it did happen occasionally to those covered by Medicare.

New information has just come out about what changes can be expected starting January 1 of next year.

All health care providers must make information on patients’ rights with respect to balance billing publicly available.

Health plans are expected to share more information on their websites explaining surprise billing (when a patient is responsible for an amount over what a health plan pays). Plus, health plan ID cards will show deductibles and out-of-pocket maximums.  We assume these new changes will also apply to Medicare although we have not seen information specifically about that.