The No Surprises Act is a federal law designed to protect patients from unexpected medical bills that arise when they unknowingly receive care from out‑of‑network providers. Enacted in 2022, it bans most forms of “balance billing” for emergency services, air ambulance transport, and non‑emergency care delivered at in‑network facilities by out‑of‑network clinicians. Instead of leaving patients caught in the middle, the law shifts payment disputes to insurers and providers through a defined negotiation and arbitration process. At its core, the Act aims to restore financial predictability for patients and bring greater transparency to how healthcare costs are communicated and billed.
Listen in to this 5-part series with attorneys Adam Russo and Scott Bennett of The Phia Group as they start from the beginning of the case that made this all happen to how this is working and impacting patients, providers, payers, and health systems.
Part 1 of 5
Host Adam Russo starts his special series with Scott Bennett, Esq., Executive Vice President, Provider Relations at The Phia Group amd announcing their newest audit report findings.
Part 2 of 5
Host Adam Russo continues his special series with Scott Bennett, Esq., Executive Vice President, Provider Relations at The Phia Group discussing the No Surprises Act and Drew Calver, a teacher from an Austin school district, who received a $160,000 medical bill after a heart procedure which sparked the legislation.
Part 3 of 5
Host Adam Russo continues his special series with Scott Bennett, Esq., EVP, Provider Relations at The Phia Group continuing their discussion on the No Surprises Act (NSA). In this part, Scott discusses the independent dispute resolution (IDR) processes and how the NSA has shifted costs from patients to employers, particularly in self-funded plans, with providers winning arbitration cases 74% of the time and often receiving 3-5 times the Qualified Payment Amount (QPA).
Part 4 of 5
Host Adam Russo continues his special series with Scott Bennett, Esq., EVP, Provider Relations at The Phia Group continuing their discussion on the No Surprises Act (NSA). This part, Scott details two extreme billing cases. One involving a photographer who was bitten by a bat during a photography session and the other an ambulance bill for a non-emergency 6-mile transport of a runner with a broken toe and minor concussion.
Part 5 of 5
Host Adam Russo concludes his special series with Scott Bennett, Esq., EVP, Provider Relations at The Phia Group concluding their discussion on the No Surprises Act (NSA). In this part focusing on a specific case involving neuromonitoring charges. The patient received a $94,031 bill for intraoperative neuromonitoring (IONM) services during her spinal surgery.