PHILADELPHIA, Pa. (WHTM) — Gov. Tom Wolf was joined in Philadelphia Monday afternoon by Pa. Insurance Department and local stakeholders to take executive action to support Pa.’s implementation of the federal No Surprises Act on Jan. 1, 2022. The act will protect patients from receiving surprise medical bills.
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“A patient who has carefully researched and selected an in-network facility and provider or is seeking care because of an emergency should not be stuck with out-of-network costs and billing when they had little or no choice regarding providers that may, in the end, be out-of-network,” said Gov. Wolf.
The act will protect patients from surprise bills — which are unexpected medical bills that a patient receives when they unintentionally obtain health care from a provider that is outside their plan’s provider network — by requiring that emergency services are billed as in-network without needing prior approval. Plus, certain non-emergency services will also be covered as in-network.
According to the press release, the act will also ban other out-of-network charges and balance billing without advance notice. Instead, patients will now receive a plain-language consumer notice explaining that patients consent to receive care on an out-of-network basis before that provider can bill the patient.
Having a medical emergency is stressful enough, and no one should have that stress intensified by receiving a surprise bill for accessing the care that they need. It’s time that we protect patients instead of insurance companies,” House of Representatives member Brian Sims said.
With the executive order signed to coordinate implementation of the No Surprises Act in the Commonwealth, patients who receive surprise medical bills for services provided on or after Jan. 1, 2022, may contact the Insurance Department by clicking here for help or to view the FAQ for next steps.
For more information, visit the Insurance Department’s website by clicking here.