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No Surprises Act Prevented More Than 2M Surprise Bills in First Two Months

Analysis  |  By Jay Asser  
   June 10, 2022

A survey from AHIP and the Blue Cross Blue Shield Association (BCBSA) finds that the law protected millions of patients immediately after going into effect.

In its first two months as a law, the No Surprises Act protected patients from more than two million surprises bills, according to a survey from AHIP and BCBSA.

After being signed into law in December 2020, the No Surprises Act went into effect on January 1, 2022, with the purpose of ending surprise medical bills for out-of-network services.

"The No Surprises Act ended the practice of surprise medical billing in most circumstances, providing relief for millions of patients who faced surprise medical bills they did not expect at prices they could not afford," said Matt Eyles, AHIP president and CEO. "Health insurance providers applaud the Administration and Congress for taking this important step. But more work needs to be done to ensure a broken bone doesn't break the bank."

The survey conducted by AHIP and BCBSA examined the number of claims that were eligible for dispute under the No Surprises Act in the first two months of 2022. Of the 83 commercial health plans surveyed, 31 plans—representing 54% of the total commercial market—responded.

Eligible claims included emergency services by an out-of-network provider and non-emergency services by an out-of-network provider at an in-network facility.

The research found 600,000 claims, or 0.23% of the plans' responses, eligible for protection under the No Surprises Act.

Taking into account delays in claims processing, the researchers then calculated the share of eligible claims per enrollee before multiplying that number by the 2020 Census estimate of the total number of commercial enrollees (213 million).

The result was the final estimate of more than two million surprises bills avoided across all commercially insured patients, which would project to over 12 million surprises bills prevented for all of 2022.

AHIP and BCBSA note that even if only a fraction of these claims are ultimately disputed through the independent dispute resolution process, it would still greatly exceed the estimate of 17,000 annual claims by the government.

"There is no room for surprise medical bills in a health care system that puts people first," said Kim Keck, BCBSA president and CEO. "As recently as last year, an emergency visit to the hospital may have left patients on the hook for steep, surprise medical bills. The No Surprises Act has not only put an end to this loophole, but it has provided undeniable financial protection to millions of Americans."

Jay Asser is the contributing editor for strategy at HealthLeaders. 

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