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Not All Surprises Are Good – Phase I of the Surprise Billing Rules

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On July 1, 2021, the Office of Personnel Management, Department of the Treasury, Department of Health and Human Services, and Department of Labor issued the interim final rule “Requirements Related to Surprise Billing; Part I” (the “IFR”), which is the first phase of regulations implementing the No Surprises Act. The No Surprises Act provides certain protections against surprise medical bills and was signed into law on December 27, 2020 as part of the Consolidated Appropriations Act, 2021.

The No Surprises Act and the IFR do not completely eliminate surprise billing, but they provide relief from some of the more common scenarios when an individual may experience high and unexpected medical costs. Those scenarios include surprise medical bills from:

  1. emergency services;
  2. non-emergency services performed by nonparticipating providers at participating health care facilities; and
  3. air ambulance services.

For more information about the No Surprises Act and its impact on employer-sponsored group health plans, see our SW Benefits Update, “Not All Surprises Are Good – Phase I of the Surprise Billing Rules.”