Whopping medical bills are an unfortunate fact of life for many Americans. And they often come as a complete surprise to patients. We’ve all had personal experiences or heard horror stories from folks who have gone to an emergency room for a few stitches and walked out with a bill for thousands of dollars. Even patients with excellent insurance coverage aren’t immune from unexpected–often ridiculously high–charges.
The good news is that newly enacted federal legislation known as the No Surprises Act now prevents emergency rooms and out-of-network providers from hitting patients with surprise medical bills. The legislation is designed to curb excessive out-of-pocket costs for consumers. It’s a significant victory for patients’ rights.
As of January 1, 2022, certain providers can no longer engage in “balance billing.” Balance billing is a common practice where providers bill patients directly for costs not covered by their insurance companies. Until this year, many patients have learned the hard way about this all-too-common practice, getting a surprise bill for care they assumed would be covered by insurance. The new law applies to emergency care, non-emergency care from out-of-network providers at in-network facilities and costly air ambulance services. It’s a game-changer on several levels:
- Emergency care at an in-network hospital may involve some treatment from an out-of-network provider. The problem is that when you get emergency care, you don’t usually get to choose your provider. This can leave well-insured patients with staggering bills–even if they go to an in-network hospital.
- Even the most basic visit to the emergency room, including an examination and x-rays can mean a bill of several thousand dollars or more. In the past, if the hospital or provider was not in your insurance network, those fees fell into the consumer’s lap.
- As far too many patients have learned, a bill for the cost of helicopter transport to the hospital can be crippling. Air ambulances are almost always out of network and can cost upwards of $50,000 or more. A bill for tens of thousands of dollars is the last thing patients should have to deal with after a serious accident.
- The No Surprises Act also benefits uninsured patients. According to the Centers for Medicare and Medicaid, the legislation provides new dispute resolution opportunities for uninsured and self-pay patients when they receive medical bills that could be considered unreasonable.
As most of us know, the cost of medical care in the U.S. is exorbitant. In certain circumstances, medical bills are nothing short of crippling for patients who urgently need treatment. The No Surprises Act is a huge step forward in protecting consumers from excessive out-of-pocket costs. It addresses a serious flaw in our healthcare system and will have ripple effects through the world of personal injury law and beyond.
However, we know that a single piece of legislation won’t put an end to devastating medical bills. The serious injury cases we handle at Burnett & Williams often involve a combination of broken bones, surgery, and overnight hospitalization. Hospital costs can quickly soar to six figures or more. As personal injury attorneys, we’ve seen the damaging effects of balance billing, which can leave clients on the hook for thousands– or tens of thousands– of dollars. We’re encouraged by this step in the right direction. But we understand that the No Surprises Act does not mean an end to negligence or skyrocketing medical bills. An experienced personal injury firm can help you navigate the process and use the new legislation and other strategies to recover the costs of needed medical care, lost wages and beyond.
If you or someone you know has been seriously injured as the result of someone else’s negligence, please call our team of attorneys at Burnett & Williams at 703-777-1650 for a free consultation.