New law targets surprise medical bills

A hospital visit is stressful enough and that stress can be compounded when people are left with surprise medical bills and discover that visiting an in-network provider doesn’t guarantee you’ll be covered.

Now there’s a new law aimed at ensuring patients aren’t left with unexpected costs.

Patricia Kelmar is the director of health care campaigns at the U.S. Public Research Interest Group (PIRG) and said that patients typically have no way of knowing what will be covered during a hospital visit because while a hospital may be in-network, not everyone who works there will be.

That results in surprise separate bills from specialists such as anesthesiologists, even though you had no choice in receiving their services.

“It might have been a radiologist or a scrub-in assistant and those bills can be very expensive,” said Kelmar.

After years of advocacy, PIRG has helped find a federal solution that takes consumers out of the middle with a new law that will go into effect in January 2022. The No Surprise Act will also apply to emergency room visits and air ambulance services. The first set of implementing regulations will go into effect July 1.

“We haven’t seen any kind of bill like this in years and really what it’s going to do is protect consumers. Providers won’t be able to send out-of-network bills any more,” Kelmar said.

Kelmar added that there will soon be a federal hotline to help guide consumers once the law is in effect, but for now, be sure to check that every provider you see during a visit is covered by your insurance.

You can find more information on laws protecting Virginia residents here and guidance on navigating surprise medical bills in Maryland here.

Melissa Howell

Melissa Howell joined WTOP Radio in March 2018 and is excited to cover stories that matter across D.C., as well as in Maryland and Virginia. 

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