What is the The “No Surprises Act”?

The “No Surprises Act” aims to increase transparency in medical costs and protect clients from “surprise” medical bills caused by out-of-network care. This act was set in motion on Jan. 1, 2022.

Sometimes people carefully select an in-network medical provider only to discover their medical bill is much higher than they expected because they unknowingly received medical care from an out-of-network provider during their service. This balanced billing requirement aims to prevent that potential sticker shock by prohibiting providers who are out-of-network with a client’s insurance from charging more than their in-network costs when clients receive care at the in-network facility.

Under this act, counselors are to provide clients with what’s called a “Good Faith Estimate” (GFE) for recurring services (such as ongoing counseling visits), which is good for one year. The GFE is just an estimate; it is not legally binding and may change at any point. However, if the actual charge is more than $400 above the estimate, the client has the right to dispute the charge.