Good news for a change! Federal law intended to limit “surprise” medical bills appears to be working

When it comes to health care costs, Voices for Affordable Health often shares sobering news. But a new study from the Urban Institute and the Georgetown University Center on Health Reforms finds a new federal law intended to protect patients from excessive and unexpected medical bills is having a positive effect.

“Surprise” or “balance” bills often happen when patients are treated by a clinic or hospital in their insurance network but are seen by a doctor or specialist who isn’t. The patient is then on the hook for what is often a very high bill – sometimes exceeding thousands of dollars. 

The “No Surprises Act,” which became federal law in January 2022, was designed to limit such out-of-network charges.

Researchers interviewed 32 regulators and stakeholders representing consumers, payers, hospitals, billing companies and other industry players. They found a marked decline in consumer complaints since the “No Surprises Act” took effect.

“One consumer group, which fielded a significant number of surprise billing complaints in past years, reported having not received one complaint about No Surprise-Act surprise billing in 2022,” the researchers wrote. “Similarly, an employer coalition said that before the No Surprises Act, there was enough noise to know there was a problem (with balance billing); since then, we have no noise in this area.”

Before we break out the party hats and balloons, researchers noted that it’s still far too early to draw any long-term conclusions. More work needs to be done to educate consumers about their rights. And the year has pointed to some coverage gaps – including ground ambulance services – where Congress may need to tighten protections.

Have you received a “surprise” medical bill in the past year? We’d love to hear about it. Share your story with Voices for Affordable Health.