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No Surprises Act

No Surprises Act By: Alex Reger, Principal Analyst January 20, 2022 | 2022-R-0012. Issue Briefly summarize the surprise billing provisions of the federal No Surprises Act ( 116-260, Division BB, Title 1), including the state's role in establishing provider reimbursement amounts for these bills. The Office of Legislative Research is not authorized to provide legal opinions and this report should not be considered one. Summary The federal No Surprises Act, established as part of the Consolidated Appropriations Act of 2021, places requirements on health insurers and health care providers that are designed to protect consumers in surprise billing situations.

Generally, the act requires group health plans (i.e., employer sponsored plans governed under ERISA) and group and individual health insurance policies that cover emergency services to cover them: 1. without the need for prior authorization; 2. regardless of whether the provider is in- or out-of-network; and 3.

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