Under the law, effective upon plan years beginning on or after January 1 2022, out-of-network providers are prohibited from pursuing members directly for balance medical bills in situations where they have little or no control over who provides their care, like for all emergency services (except ground ambulance), or when an out-of-network provider is involved in their care while they are at an in-network facility.
If a patient receives a service that is covered by the No Surprises Act, the law caps the patient’s cost share to what it would be if the services were provided in-network.