The No Surprises Act* introduced new requirements for providers, facilities, and providers of air ambulance services to protect individuals from surprise medical bills. These requirements:

• Prohibit providers and facilities from directly billing individuals for the difference between the amount they charge and the amount that the individual’s plan or coverage will pay plus the individual’s cost-sharing amounts (i.e., balance billing) in certain circumstances;

• Require providers and facilities to provide good faith estimates of charges for care to uninsured (or self-pay) individuals upon scheduling care or on request, and for individuals with certain types of coverage, to submit good faith estimates to the individual’s plan or issuer;

• Create a patient-provider dispute resolution process for uninsured (or self-pay) individuals to contest charges that are “substantially in excess” of the good faith estimate;

• Require certain providers and facilities to publicly disclose restrictions on balance billing; and

• Limit billed amounts in situations where a provider’s network status changes mid-treatment or

individuals act on inaccurate provider directory information.
* Title I (No Surprises Act) of Division BB of the Consolidated Appropriations Act, 2021 (CAA) amended title XXVII of the Public Health Service Act (PHS Act).