Surprise medical bills are the target of a new law. Here’s how it works : Shots

The No Surprises Act is intended to stop surprise medical bills. It could also slow the growth of health insurance premiums.

J. Scott Applewhite/AP


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J. Scott Applewhite/AP


The No Surprises Act is intended to stop surprise medical bills. It could also slow the growth of health insurance premiums.

J. Scott Applewhite/AP

The new year brings new protections for patients with private health insurance who will no longer be blindsided by “surprise” medical bills when they unknowingly receive out-of-network care.

The No Surprises Act, passed by Congress in 2020 as part of the coronavirus relief package, takes effect Jan. 1.

It generally forbids insurers from passing along bills from doctors and hospitals that are not covered under a patient’s plan — such bills have often left patients to pay hundreds to tens of thousands of dollars in outstanding fees. Instead, the new law requires health care providers and insurers to work out a deal between themselves.

Here’s how the law will work and how it might affect insurance premiums and the health care industry.

It may slow premium growth

Some observers have speculated that the law will have the unintended consequence of shifting costs and leading to higher insurance premiums. But many policy experts told KHN that, in fact, the opposite may happen: It may slightly slow premium growth.

The reason, said Katie Keith, a research faculty member at the Center on Health Insurance Reforms at Georgetown University, is that a new rule released Sept. 30 by the Biden administration appears to “put a thumb on the scale” to discourage settlements at amounts higher than most insurers generally pay for in-network care.

That rule, which provides more details on the way such out of network disputes will be settled under the No Surprises Act, drew immediate opposition from hospital and physician groups. The American Medical Association called it “an undeserved gift to the insurance industry,” while the American College of Radiology said it “does not reflect real-world payment rates” and warned that relying on it so heavily “will cause large imaging cuts and reduce patient access to care.”

In early December, the AMA, joined by the American Hospital Association, filed a lawsuit challenging a part of that rule that outlines the factors that arbitrators should consider in determining payment amounts for disputed out-of-network bills. The case does not seek to halt the entire law, but does want changes to that provision, which it says unfairly benefits insurers. Later in the month, groups representing emergency physicians, radiologists and anesthesiologists filed a similar lawsuit.

Such tough talk echoes comments made while Congress was hammering out the law.

Unsettled bills will go to arbitration

The No Surprises Act takes aim at a common practice: large, unexpected “balance bills” being sent to insured patients for services such as emergency treatment at out-of-network hospitals or via air ambulance companies. Some patients get bills even after using in-network facilities because they receive care from a doctor there who has not signed on

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Hackers Target Newfoundland’s Health Care System

For a lot of months now, the people of Newfoundland and Labrador have experienced to put up with canceled or delayed health care treatments and appointments. For a lengthy time — like folks in the relaxation of Canada, and all around the world — their predicament was thanks to the pandemic.

But currently, the hassle has arrive from a new resource — a catastrophic cyberattack. The method ground to a halt on Oct. 30. On Friday, the province’s 4 wellness authorities had been predicting that procedure delays and disruptions would get started easing on Monday, even though they would persist in some crisis departments and not all elective surgical procedures and chemotherapy treatments would return to standard.

And this 7 days, the province exposed that the assault was even worse than formerly documented. On Friday, John Hogan, the provincial justice minister, reported that employee details at three neighborhood health and fitness authorities had been stolen. Two times earlier, officers said that personal details of people and wellness treatment personnel, some of it health and fitness-linked, experienced been “accessed” through the attack.

It was, in limited, a cyberattack that theoretically affected everyone in the province.

But fantastic luck finding out what happened or what’s likely on to remedy it. The government of Leading Andrew Furey, who is also an orthopedic surgeon, won’t even describe the wide range of the cyberattack.

“Our assistance from earth-course experts is to say nothing at all,” John Haggie, Newfoundland’s wellness minister, instructed a information convention on Wednesday. Nor will the government expose who individuals authorities are that the province brought in to solve its issue.

The Canadian Broadcasting Company, without the need of revealing its resource, noted that the shutdown was the most recent in a string of ransomware assaults that have hit other wellness-relevant institutions, corporations and governments throughout the pandemic. These kinds of attacks made about a decade or so back. The attacks, which look to generally arrive out of Russia, simply just involve seizing manage of details on vulnerable computer methods, encrypting it and then threatening to wipe out it unless of course a ransom is compensated, usually in bitcoin.

3 hospitals in Ontario were being victims of these kinds of assaults in October 2019. They have disrupted individuals’ private computer systems, and early this year they designed diesel and jet fuel shortages in the United States soon after a pipeline business fell target to hackers.

I spoke with Nicolas Papernot, an assistant professor of laptop or computer science and computer engineering at the University of Toronto. Even though he is an internationally identified specialist on cybersecurity and privacy, he’s not amongst Newfoundland’s advisers and has no within awareness of its circumstance.

“I do not know why they never give far more facts,” he stated. “But they ought to at least give a warning to people who are most likely influenced, even if they are conservative in how they estimate regardless of whether a particular person was or was not impacted by

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