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Lawsuits challenge No Surprise Act

Reno KOLO-TV logo Reno KOLO-TV 4/7/2022 John Macaluso
KOLO © Provided by Reno KOLO-TV KOLO

RENO, Nev. (KOLO) - One in five insured Americans who have surgery or visit an emergency room will receive a surprise medical bill.. These bills can cost thousands of dollars.

The No Surprises Act passed through Congress in 2020 and went into effect on January 1, but is now facing six lawsuits from physicians and hospitals around the county.

Surprise bills usually happen because of out of network factors. Typically, insurance companies negotiate with different providers, then patients pay for things like the in-network co-pays. When an out of network provider gets involved, an extra bill is added and insurance won’t cover that, meaning the patient is stuck with the bill.

“That can be hundreds to thousands of dollars.” said Patricia Kelmar, Healthcare Campaigns Director at U.S. PIRG. “It’s common from anesthesiologists, radiologists, ambulances, those kind of providers that have a captive audience. You haven’t chosen them. They just get to take care of you and send you a big bill.”

The No Surprises Act prohibits these kind of bills from being sent to patients. As of January 1, 2020, you should only be responsible for co-pays and deductibles. The lawsuits filed include The American Hospital Association and The American Medical Association. They argue the Biden Administration’s interpretation of the act unfairly benefits health insurers.

After a medical visit, always make sure to look over your bill. Any charge that looks outrageous could be a surprise bill. Work with your insurance company to see whether or not it is an illegal bill.

There is also a hot-line you can call to learn about your rights. It’s 1-800-985-3059.

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