Law May Stop 9.6 Million Surprise Medical Bills a Year

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9.6 million

That’s how many medical bills a new ban on out-of-network surprises may apply to each year, including an estimated 18% of privately insured patients’ emergency room bills. 

Thanks to the federal government’s No Surprises Act, which took effect Jan. 1, people with employer-provided insurance, private insurance, or Obamacare plans will be protected against many forms of so-called surprise medical bills. These often occur when patients need emergency room care or go to a hospital or doctor’s office in their insurance network, but are charged high out-of-pocket bills because they received care from someone there (such as an anesthesiologist) who was outside the network. 

Patients who receive surprise bills despite the new regulations have a new way to dispute bills, through an independent federal review process. Patients can file an appeal—using a procedure described on their denial notice—and if all else fails, they can file a complaint with the Center for Medicare and Medicaid Services using a new website or by calling the new No Surprises Help Desk at 1-800-985-3059.

The 9.6 million bills, a calculation based on a Kaiser Family Foundation analysis of government data, includes 7.1 million for emergency room visits. Surprise bills for childbirth average $744, according to one recent study, and for an air ambulance or medevac ride, $21,698. 

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