Surprise billing regulation protects patients as Congress intended

In advance of the Jan. 1 implementation of the No Surprises Act, the American Heart Association, a global force for healthier lives for all, is urging the Biden administration to implement regulations as proposed to ensure patients receive the protections they were promised from financially devastating surprise medical bills.

In a letter sent today to the departments of Health and Human Services, Treasury and Labor, the American Heart Association calls on the administration to move forward with its interim final rule setting up an independent dispute resolution (IDR) process that protects patients, as the No Surprises Act intended.

"As an advocate for patients, many of whom have received a surprise bill, we have urged the administration to develop regulations that will ensure that the NSA achieves its original intent by removing patients from payment disputes, shielding them from surprise medical bills and ultimately protecting patients from increased out-of-pocket costs and increased premiums," the letter states. "As drafted, we believe that the interim final rule achieves these important goals."

The No Surprises Act represents a significant milestone in the fight to end surprise medical billing. Ahead of the law taking effect, the American Heart Association mobilized its nationwide network of cardiovascular disease patients, their families and other supporters to urge the White House and Congress to support strong implementation of the law. Thousands of You're The Cure advocates contacted lawmakers asking for rigorous implementation of the law that takes patients out of the middle of payment disputes and protects them from the devastating impact of unexpected medical bills.

"Patients must be able to focus on their urgent medical needs and recovery—they shouldn't have to worry whether they'll be able to afford unexpected care not covered by insurance," said Nancy Brown, the American Heart Association's Chief Executive Officer. "The No Surprises Act promises to make a truly meaningful difference for the millions of patients who will benefit from these new protections starting in the new year."

The letter asks for the administration to maintain or fortify guidelines included in the interim final rule, such as:

• A robust patient education campaign to notify consumers of their new rights under the No Surprises Act.
• A requirement for uninsured and self-pay individuals to receive a good faith estimate of charges in advance of their scheduled medical care.
• A revised threshold for uninsured and self-pay individuals to initiate a dispute when billed for an amount that exceeds the good-faith estimate.
• The extension of external review to surprise billing issues to allow consumers to appeal under a number of different circumstances.
• An IDR process that will produce reliable and consistent results that do not have an inflationary impact on health care costs.

Provided by American Heart Association