New Law Prohibits Surprise Medical Bills

Reprint from The New York Times, December 30, 2021 For years, millions of Americans with medical emergencies could receive another nasty surprise: a bill from a doctor they did not choose and who did not accept their insurance. A law that goes into effect Saturday will make many such bills illegal. The change is the result of bipartisan legislation passed during the Trump administration and fine-tuned by the Biden administration. It is a major new consumer protection, covering nearly all emergency medical services, and most routine care. Even with insurance, emergency medical care can still be expensive, and patients with high deductible plans could still face large medical bills. But the law will eliminate the risk that an out-of-network doctor or hospital will send an extra bill. Currently, those bills add up to billions in costs for consumers each year. Behind the scenes, medical providers are still fighting with regulators over how they will be paid when they provide out-of-network care. But those disputes will not interfere with the law’s key consumer protections. If you are having a medical emergency and go to an urgent care center or emergency room, you can’t be charged more than the cost-sharing you are accustomed to for in-network services. This is where the law’s protections are the simplest and the most clear for people with health insurance. You will still be responsible for things like a deductible or a co-payment. But once patients make that normal payment, they should expect no more bills.


Nothing is harder to deal with than unexpected medical bills.  It is on thing to have a bill from a doctor or hospital you contracted with, but surprise bills from other providers is a soul killer.  You never contracted with these providers, the doctor or hospital you used did.  Yet, until now, you were responsible for the unexpected and unapproved bills.  This new law evens the playing field.  Supposedly you do not have an obligation to pay these surprise creditors.  Only time will tell how this new law shakes out, but it is a good start to helping protect the consumer.

– Diane L. Drain

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