Regulators Release Surprise Billing Dispute Resolution Details in New Rule

• November 12, 2021

• Alexandra M. Lucas , Reed Smith LLP
• Jennifer B. Cook , Reed Smith LLP
• Christian Martin , Reed Smith LLP

The No Surprises Act (NSA), enacted in late 2020 as part of the Consolidated Appropriations Act of 2021, protects patients from surprise medical bills when they receive emergency services, non-emergency services from nonparticipating providers at participating facilities, and air ambulance services from nonparticipating providers.[1] The NSA limits a patient’s cost-sharing to in-network levels, prohibits balance billing, and establishes a baseball-style arbitration independent dispute resolution process (IDR) to allow payors and providers to resolve disputes over provider payments.[2] It is effective for all plan and policy years beginning on or after January 1, 2022.