The No Surprises Act: Practical implications for health and mental health professionals

Abstract

The No Surprises Act dictates that the arbiter chooses the offer closest to the median in network rate, unless there is additional information that shows that the in-network rate is inappropriate. Many provider groups — including the American Hospital Association and American Medical Association — are engaged in litigation with the government, contending in part that the “median in-network rate goes against Congress’ intent in passing the law by disregarding other factors that should be considered.” Will the No Surprises Act survive judicial scrutiny? That remains to be seen. In the interim, hospitals, insurance companies, mental health providers, and patients must scurry to be compliant.