Stephanie Armour
speaker
133 appearances
3 recordings
1 series
first heard Jul 2021
last heard Feb 2023
Stephanie Armour’s voice in public audio — every appearance, attributed to the second.
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Appearances
The Affordable Care Act did put caps on how much you may have to spend out of pocket, but that's for in-network care.
So it kind of left this loophole, which has increasingly eaten up out-of-pocket spending for consumers when it comes to health care.
And that's where the focus has been on, let's try and do away with these surprise bills and protect consumers from these costs.
The first, there's going to be more that implement the No Surprises Act, which was passed by Congress in December 2020.
And the No Surprises Act basically sought to protect patients from getting these surprise bills, but it has to be implemented through rules.
And the first rule to come out is pretty broad in scope.
It basically says, look, if you get emergency care, you can't get a surprise medical bill if you were seen by someone out of network.
And it also basically says that if you go in a non-emergency situation, you also need to be informed upfront about what the cost would be so that you're not surprised.
So there's a lot of different components to this interim final rule, but basically it sets up the buffer that protects patients from these surprise bills and implements what health organizations have to do.
It's emergency services, regardless of where they're provided, that have to be billed at the lower in-network rates.
But it also includes some out-of-network that basically has to do that mean that you have to be aware as a consumer.
Yeah, you have to be informed ahead of time.
It can't be like you go to this out-of-network facility and you get this big charge or you're seen by someone out-of-network and you get a big charge.
You have to be informed as a consumer ahead of time what those costs will be, especially if it comes to cost-sharing, copayments that you may have to pay.
So those...
You have to be informed of, and any of those co-payments that you make, like this is like your co-insurance, your deductible, they can't be higher than if those services were provided by an in-network doctor.
The reason the interim final rule doesn't go in effect until January 1st is that is when the law itself takes effect.
So therefore, it doesn't go in effect until then.
But during that time, there's going to be a public comment period on the interim final rule.
So people can comment on what they think about it or groups can in the next 60 days.
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