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The No Surprises Act is a US federal law (effective 2022) that protects patients from most surprise out-of-network medical bills for emergency care and in-network facility care.
Before the No Surprises Act, patients who received care at an in-network hospital from an unknowingly out-of-network anesthesiologist, radiologist, or pathologist would receive surprise bills at out-of-network rates — often thousands of dollars. The Act prohibits this practice for federally-regulated insurance plans and creates a federal dispute resolution process for billing disagreements.
A patient has emergency surgery at an in-network hospital. The anesthesiologist on call is out-of-network. Before the No Surprises Act, the anesthesiologist could bill the patient at out-of-network rates (often $3,000-$8,000 above what insurance covers). After the Act, the patient is only liable for their normal in-network cost-sharing; the provider and insurer must resolve any payment disputes between themselves.
What's still NOT protected: Ground ambulance bills (surprisingly excluded from the Act), care from providers a patient knowingly chose out-of-network, and bills not covered by federally-regulated plans. How to dispute a violation: File at cms.gov/nosurprises.