More than a year ago, the U.S. healthcare system marked a turning point with the passage of federal legislation that went into law intending to protect Americans from unexpected provider charges, a once common practice known as “balance billing.” Taking effect January 1, 2022, the No Surprises Act (NSA) covers patients and participants in employer-sponsored health plans with protections from “surprise” bills issued following certain emergency services and care received from out-of-network providers at in-network facilities. Experts say bipartisan support of the NSA was a rare victory for patients and the public against exploitative health care costs, but challenges and uncertainties remain.
For employer-sponsored health plans whose participants continue to receive unexpected medical bills and struggle with unresolved disputes that impact their health and wealth, aequum is providing needed insight and support with the launch of a dedicated website specific the NSA.
By visiting https://knowthenosurprisesact.com, employers, plan sponsors, third party administrators, brokers payers and participants can access a portal to everything NSA, including current federal rules and regulations, valuable updates on current litigation, news and developments, as well as resources that guide health plan compliance.
Christine Cooper, CEO of aequum, explains, “Our team is at the nexus of discussions and activities surrounding NSA and is implementing this resource center to help advise the industry with a better understanding of the rules, regulations and rights under the NSA. We are proactively responding to the needs of our partners, clients and their members, helping to protect them against unreasonable medical charges and balance-billing.”
Newly launched website exemplifies aequum as agents of change.
According to aequum member Jack Towarnicky, “The NSA can empower employer-sponsored, self-funded plans by spearheading a shift towards healthcare consumerism – putting participants in the driver’s seat,” continues Towarnicky.
NSA compliance remains a top priority for plan administrators and the most effective way to address the NSA is through a combination of strategic and compliance-oriented approaches. This may include adopting a “pure” reference-based pricing (RBP) plan design to limit plan benefits and participant out-of-pocket costs to the true cost of provider services.