"Surprise" Billing

ACR® action helped ensure that federal “surprise” medical bill legislation signed into law as part of the Consolidated Appropriations Act, 2021, held patients harmless and created an equitable process for provider-insurer dispute resolution.

At ACR urging, Congress:

  1. Removed the monetary threshold to access independent dispute resolution;
  2. Removed provisions using the median in-network rate as an initial benchmark for payment;
  3. Inserted language to explicitly exclude Medicare, Medicaid and workers’ compensation payment rates from consideration in the independent dispute resolution process; and
  4. Removed the problematic timely billing provisions.

The new law represents a significant step forward for patients and providers. The ACR and others in the physician community will monitor the regulatory processes associated with scheduled 2022 implementation of these protections and update members as information becomes available.