The No Surprises Act was signed into law in late 2020 after years of negotiation between health plan insurers, employers, and providers regarding the elimination of "surprise" medical bills. The bill represents a sea change in the way that providers can bill and be reimbursed for "out-of-network" services. This update provides an overview and analysis of the law and recent legal challenges to a portion of the law.

Background: The No Surprises Act is intended to eliminate surprise medical bills often received by patients from medical providers that are not part of an insurance plan's or other payor's preferred network of providers. This is often referred to as "balance billing" because the out-of-network provider bills a patient directly for the part of the bill that is not covered by insurance (the balance). Often, patients will assign their right to collect from the payor to the provider and the provider attempts to recover directly from the payor. Continue reading >