{"id":1539,"date":"2021-12-28T08:00:38","date_gmt":"2021-12-28T14:00:38","guid":{"rendered":"https:\/\/www.bbrown.com\/?post_type=insight&#038;p=1539"},"modified":"2023-04-25T16:04:26","modified_gmt":"2023-04-25T21:04:26","slug":"fundamentals-of-the-no-surprises-act","status":"publish","type":"insight","link":"https:\/\/www.bbrown.com\/us\/insight\/fundamentals-of-the-no-surprises-act\/","title":{"rendered":"Fundamentals of the No Surprises Act"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><p>[vc_row row_style=&#8221;page-hero&#8221; full_width=&#8221;stretch_row_content&#8221;][vc_column]\n\t<div class=\"hero hero--wrap    \">\n\n\t\t<div class=\"hero--background-image hero--background-image-blur\">\n\t\t\t<div class=\"hero--overlay\"><\/div>\n\t\t\t\t\t\t\t<div class=\"hero-background\" style=\"background: url(https:\/\/www.bbrown.com\/wp-content\/uploads\/2022\/01\/AdobeStock_322352588-scaled.jpeg) center center no-repeat; background-size: cover;\"><\/div>\n\t\t\t\t\t<\/div>\n\n\t\t<div class=\"hero--container\">\n\t\t\t<div class=\"container\">\n\t\t\t\t<div class=\"hero--inner width-100\">\n\n\t\t\t\t\t\n  <div class='content-heading  100%  '>\n    <p class='text-white subheading'>Employee Benefits<\/p>\n    <h1 class='text-white    '>\n      Fundamentals of the No Surprises Act\n    <\/h1>\n\t\n  <\/div>\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\n\t<\/div>\n\n\t\n[\/vc_column][\/vc_row][vc_row][vc_column width=&#8221;2\/3&#8243;]\n  <div class='content-heading  100% content-heading--ruled '>\n    \n    <h1 class='text-brand-dark-blue    h2'>\n      Fundamentals of the No Surprises Act\n    <\/h1>\n\t\n  <\/div>[vc_column_text]On December 27, 2020, President Trump signed Congress\u2019 $900 billion COVID-19 relief package. As expected, the final bill includes the language of the \u201cNo Surprises Act,\u201d a long-anticipated, largely bipartisan bill that provides patient protections against surprise medical bills from out-of-network providers. This act will have significant impact on the health care industry, including group health plans offered by our customers. Included below is a summary of the major provisions of the landmark legislation.<\/p>\n<h3>Health Plan Surprise Medical Billing Requirements<\/h3>\n<ul>\n<li>Participants and beneficiaries cannot be required to pay anything other than the in-network cost-sharing amounts for:\n<ul>\n<li>Out-of-network emergency care,<\/li>\n<li>Out-of-network air ambulance services,<\/li>\n<li>Certain ancillary services provided by out-of-network providers at in-network facilities, and<\/li>\n<li>Out-of-network care provided at in-network facilities when the patient has not provided informed consent.<\/li>\n<\/ul>\n<\/li>\n<li>Any cost-sharing payments by participants and beneficiaries for out-of-network emergency services and air ambulance services must be counted towards any in-network deductible or out-of-pocket maximums.<\/li>\n<li>Participants will not be involved in billing disputes between health care providers and insurers.<\/li>\n<\/ul>\n<h3>Determining Out-of-Network Rates Paid by Health Plans<\/h3>\n<ul>\n<li>Establishes an independent dispute resolution (IDR) process when providers and insurers are unable to settle out-of-network claims within a 30-day negotiation period.<\/li>\n<\/ul>\n<h3>Health Care Providers Surprise Medical Billing Requirements<\/h3>\n<ul>\n<li>Participants and beneficiaries may not be billed by out-of-network facilities and providers for amounts exceeding the in-network cost-sharing amount for certain emergency care and ancillary services.<\/li>\n<li>Unless the patient is given notice of the providers network status within 72 hours prior to receiving out-of-network care, and the patient consents to that care, the out-of-network provider is prohibited from balance billing the patient. When an appointment is made within 72 hours of care, the patient must receive a notice of the network status on the day the appointment is made and provide consent to receive out-of-network care.<\/li>\n<\/ul>\n<p>[\/vc_column_text]\t<div class='wpb_content_element text-left btn-container'>\n\t\t\t\t\t<a class='btn btn-brand-green  '\n\t\t\t\thref='https:\/\/www.bbrown.com\/wp-content\/uploads\/2022\/01\/Fundamentals-of-the-No-Surprises-Act-Brown-Brown_WEB.pdf' target='_blank' data-toggle=''>\n\t\t\t\t<span class=\"btn-text-color--default\">Continue Reading<\/span>\n\t\t\t<\/a>\n\t\t\t<\/div>\n[\/vc_column][vc_column width=&#8221;1\/3&#8243;][vc_single_image image=&#8221;1390&#8243; alignment=&#8221;center&#8221;][vc_separator border_width=&#8221;2&#8243; el_width=&#8221;60&#8243;][vc_column_text]<\/p>\n<h6 style=\"text-align: center;\">Regulatory and Legislative Strategy Group<\/h6>\n<p>[\/vc_column_text]\t<div class='wpb_content_element text-center btn-container'>\n\t\t\t\t\t<a class='btn btn-brand-dark-blue  '\n\t\t\t\thref='\/us\/contact\/contact-general\/' target='' data-toggle=''>\n\t\t\t\t<span class=\"btn-text-color--default\">Connect Now<\/span>\n\t\t\t<\/a>\n\t\t\t<\/div>\n[\/vc_column][\/vc_row]<\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>[vc_row row_style=&#8221;page-hero&#8221; full_width=&#8221;stretch_row_content&#8221;][vc_column][\/vc_column][\/vc_row][vc_row][vc_column width=&#8221;2\/3&#8243;][vc_column_text]On December 27, 2020, President Trump signed Congress\u2019 $900 billion COVID-19 relief package. As expected, the final bill includes the language of the \u201cNo Surprises Act,\u201d a [&hellip;]<\/p>\n","protected":false},"author":66,"featured_media":1540,"template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"insight_category":[31,73],"class_list":["post-1539","insight","type-insight","status-publish","has-post-thumbnail","hentry","insight_category-employee-benefits","insight_category-regulatory-and-legislative-strategy"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.0 (Yoast SEO v27.0) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Fundamentals of the No Surprises Act - Brown &amp; Brown<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.bbrown.com\/us\/insight\/fundamentals-of-the-no-surprises-act\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Fundamentals of the No Surprises Act\" \/>\n<meta property=\"og:description\" content=\"[vc_row row_style=&#8221;page-hero&#8221; full_width=&#8221;stretch_row_content&#8221;][vc_column][\/vc_column][\/vc_row][vc_row][vc_column width=&#8221;2\/3&#8243;][vc_column_text]On December 27, 2020, President Trump signed Congress\u2019 $900 billion COVID-19 relief package. As expected, the final bill includes the language of the \u201cNo Surprises Act,\u201d a [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.bbrown.com\/us\/insight\/fundamentals-of-the-no-surprises-act\/\" \/>\n<meta property=\"og:site_name\" content=\"Brown &amp; Brown\" \/>\n<meta property=\"article:modified_time\" content=\"2023-04-25T21:04:26+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.bbrown.com\/wp-content\/uploads\/2022\/01\/AdobeStock_322352588-scaled.jpeg\" \/>\n\t<meta property=\"og:image:width\" content=\"2560\" \/>\n\t<meta property=\"og:image:height\" content=\"1920\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.bbrown.com\/us\/insight\/fundamentals-of-the-no-surprises-act\/\",\"url\":\"https:\/\/www.bbrown.com\/us\/insight\/fundamentals-of-the-no-surprises-act\/\",\"name\":\"Fundamentals of the No Surprises Act - Brown &amp; Brown\",\"isPartOf\":{\"@id\":\"https:\/\/www.bbrown.com\/us\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/www.bbrown.com\/us\/insight\/fundamentals-of-the-no-surprises-act\/#primaryimage\"},\"image\":{\"@id\":\"https:\/\/www.bbrown.com\/us\/insight\/fundamentals-of-the-no-surprises-act\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/www.bbrown.com\/wp-content\/uploads\/2022\/01\/AdobeStock_322352588-scaled.jpeg\",\"datePublished\":\"2021-12-28T14:00:38+00:00\",\"dateModified\":\"2023-04-25T21:04:26+00:00\",\"breadcrumb\":{\"@id\":\"https:\/\/www.bbrown.com\/us\/insight\/fundamentals-of-the-no-surprises-act\/#breadcrumb\"},\"inLanguage\":\"us\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/www.bbrown.com\/us\/insight\/fundamentals-of-the-no-surprises-act\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"us\",\"@id\":\"https:\/\/www.bbrown.com\/us\/insight\/fundamentals-of-the-no-surprises-act\/#primaryimage\",\"url\":\"https:\/\/www.bbrown.com\/wp-content\/uploads\/2022\/01\/AdobeStock_322352588-scaled.jpeg\",\"contentUrl\":\"https:\/\/www.bbrown.com\/wp-content\/uploads\/2022\/01\/AdobeStock_322352588-scaled.jpeg\",\"width\":2560,\"height\":1920,\"caption\":\"American flag half-mast on top of the capitol.\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/www.bbrown.com\/us\/insight\/fundamentals-of-the-no-surprises-act\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/www.bbrown.com\/us\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Insights\",\"item\":\"https:\/\/www.bbrown.com\/us\/news-events\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Fundamentals of the No Surprises Act\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/www.bbrown.com\/us\/#website\",\"url\":\"https:\/\/www.bbrown.com\/us\/\",\"name\":\"Brown &amp; Brown\",\"description\":\"\",\"publisher\":{\"@id\":\"https:\/\/www.bbrown.com\/us\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/www.bbrown.com\/us\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"us\"},{\"@type\":\"Organization\",\"@id\":\"https:\/\/www.bbrown.com\/us\/#organization\",\"name\":\"Brown &amp; Brown\",\"url\":\"https:\/\/www.bbrown.com\/us\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"us\",\"@id\":\"https:\/\/www.bbrown.com\/us\/#\/schema\/logo\/image\/\",\"url\":\"https:\/\/www.bbrown.com\/wp-content\/uploads\/2021\/12\/cropped-BBRetail002-RGBrevs.png\",\"contentUrl\":\"https:\/\/www.bbrown.com\/wp-content\/uploads\/2021\/12\/cropped-BBRetail002-RGBrevs.png\",\"width\":1000,\"height\":136,\"caption\":\"Brown &amp; Brown\"},\"image\":{\"@id\":\"https:\/\/www.bbrown.com\/us\/#\/schema\/logo\/image\/\"}}]}<\/script>\n<!-- \/ Yoast SEO Premium plugin. -->","yoast_head_json":{"title":"Fundamentals of the No Surprises Act - Brown &amp; Brown","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.bbrown.com\/us\/insight\/fundamentals-of-the-no-surprises-act\/","og_locale":"en_US","og_type":"article","og_title":"Fundamentals of the No Surprises Act","og_description":"[vc_row row_style=&#8221;page-hero&#8221; full_width=&#8221;stretch_row_content&#8221;][vc_column][\/vc_column][\/vc_row][vc_row][vc_column width=&#8221;2\/3&#8243;][vc_column_text]On December 27, 2020, President Trump signed Congress\u2019 $900 billion COVID-19 relief package. As expected, the final bill includes the language of the \u201cNo Surprises Act,\u201d a [&hellip;]","og_url":"https:\/\/www.bbrown.com\/us\/insight\/fundamentals-of-the-no-surprises-act\/","og_site_name":"Brown &amp; Brown","article_modified_time":"2023-04-25T21:04:26+00:00","og_image":[{"width":2560,"height":1920,"url":"https:\/\/www.bbrown.com\/wp-content\/uploads\/2022\/01\/AdobeStock_322352588-scaled.jpeg","type":"image\/jpeg"}],"twitter_card":"summary_large_image","twitter_misc":{"Est. reading time":"2 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/www.bbrown.com\/us\/insight\/fundamentals-of-the-no-surprises-act\/","url":"https:\/\/www.bbrown.com\/us\/insight\/fundamentals-of-the-no-surprises-act\/","name":"Fundamentals of the No Surprises Act - Brown &amp; Brown","isPartOf":{"@id":"https:\/\/www.bbrown.com\/us\/#website"},"primaryImageOfPage":{"@id":"https:\/\/www.bbrown.com\/us\/insight\/fundamentals-of-the-no-surprises-act\/#primaryimage"},"image":{"@id":"https:\/\/www.bbrown.com\/us\/insight\/fundamentals-of-the-no-surprises-act\/#primaryimage"},"thumbnailUrl":"https:\/\/www.bbrown.com\/wp-content\/uploads\/2022\/01\/AdobeStock_322352588-scaled.jpeg","datePublished":"2021-12-28T14:00:38+00:00","dateModified":"2023-04-25T21:04:26+00:00","breadcrumb":{"@id":"https:\/\/www.bbrown.com\/us\/insight\/fundamentals-of-the-no-surprises-act\/#breadcrumb"},"inLanguage":"us","potentialAction":[{"@type":"ReadAction","target":["https:\/\/www.bbrown.com\/us\/insight\/fundamentals-of-the-no-surprises-act\/"]}]},{"@type":"ImageObject","inLanguage":"us","@id":"https:\/\/www.bbrown.com\/us\/insight\/fundamentals-of-the-no-surprises-act\/#primaryimage","url":"https:\/\/www.bbrown.com\/wp-content\/uploads\/2022\/01\/AdobeStock_322352588-scaled.jpeg","contentUrl":"https:\/\/www.bbrown.com\/wp-content\/uploads\/2022\/01\/AdobeStock_322352588-scaled.jpeg","width":2560,"height":1920,"caption":"American flag half-mast on top of the capitol."},{"@type":"BreadcrumbList","@id":"https:\/\/www.bbrown.com\/us\/insight\/fundamentals-of-the-no-surprises-act\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/www.bbrown.com\/us\/"},{"@type":"ListItem","position":2,"name":"Insights","item":"https:\/\/www.bbrown.com\/us\/news-events\/"},{"@type":"ListItem","position":3,"name":"Fundamentals of the No Surprises Act"}]},{"@type":"WebSite","@id":"https:\/\/www.bbrown.com\/us\/#website","url":"https:\/\/www.bbrown.com\/us\/","name":"Brown &amp; Brown","description":"","publisher":{"@id":"https:\/\/www.bbrown.com\/us\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/www.bbrown.com\/us\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"us"},{"@type":"Organization","@id":"https:\/\/www.bbrown.com\/us\/#organization","name":"Brown &amp; Brown","url":"https:\/\/www.bbrown.com\/us\/","logo":{"@type":"ImageObject","inLanguage":"us","@id":"https:\/\/www.bbrown.com\/us\/#\/schema\/logo\/image\/","url":"https:\/\/www.bbrown.com\/wp-content\/uploads\/2021\/12\/cropped-BBRetail002-RGBrevs.png","contentUrl":"https:\/\/www.bbrown.com\/wp-content\/uploads\/2021\/12\/cropped-BBRetail002-RGBrevs.png","width":1000,"height":136,"caption":"Brown &amp; Brown"},"image":{"@id":"https:\/\/www.bbrown.com\/us\/#\/schema\/logo\/image\/"}}]}},"_links":{"self":[{"href":"https:\/\/www.bbrown.com\/us\/wp-json\/wp\/v2\/insight\/1539","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.bbrown.com\/us\/wp-json\/wp\/v2\/insight"}],"about":[{"href":"https:\/\/www.bbrown.com\/us\/wp-json\/wp\/v2\/types\/insight"}],"author":[{"embeddable":true,"href":"https:\/\/www.bbrown.com\/us\/wp-json\/wp\/v2\/users\/66"}],"version-history":[{"count":0,"href":"https:\/\/www.bbrown.com\/us\/wp-json\/wp\/v2\/insight\/1539\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.bbrown.com\/us\/wp-json\/wp\/v2\/media\/1540"}],"wp:attachment":[{"href":"https:\/\/www.bbrown.com\/us\/wp-json\/wp\/v2\/media?parent=1539"}],"wp:term":[{"taxonomy":"insight_category","embeddable":true,"href":"https:\/\/www.bbrown.com\/us\/wp-json\/wp\/v2\/insight_category?post=1539"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}