The U.S. Department of Health and Human Services enforced the No Surprises Act that went into effect on January 1st, 2022. Consumers now have new billing protection when receiving emergency care and non-emergency care from out-of-network providers at in-network facilities. This also includes air ambulance services from out-of-network providers.
The Consumer Financial Protections Bureau (CFPB) released a compliance bulletin and policy guidance reminding debt collectors attempting to collect on or furnishing information to consumer reporting agencies regarding medical debt that is prohibited under the recently passed No Surprises Act may violate the Fair Debt Collection Practices Act (FDCPA) and Fair Credit Reporting Act (FCRA). Consumer reporting agencies could be in violation of the FCRA if they provide inaccurate consumer reports regarding such debt.
Beforehand, if patients had health coverage and received care from an out-of-network provider, their health plan usually wouldn't cover the entire out-of-network cost. This caused higher costs than if they’d been seen by an in-network provider. This is most common in an emergency situation, where the patient might not be able to choose the provider. Even if the patient goes to an in-network hospital, they might get care from out-of-network providers at that facility.
Under the FCRA and its enactment of Regulation V, debt collectors who furnish information to consumer reporting agencies must have reasonable written policies and procedures in place regarding the accuracy and integrity of the information provided to the consumer reporting agency. Debt Collectors are required to conduct a reasonable and timely investigation of a consumers disputes to verify the accuracy of their information. A debt collector who furnishes information to a consumer reporting agency concerning medical debt that exceeds the limits imposed by the No Surprises Act may violate the FCRA if it fails to accurately note this fact or fails to meet the dispute obligations regarding such debt.
Consumer reporting agencies preparing a consumer report must follow reasonable procedures to assure the maximum possible accuracy of information contained in the report, and they must conduct a reasonable and timely investigation of a consumer dispute involving the accuracy of such information in the report. A consumer reporting agency may be found to have violated the FCRA if it reports medical debt that exceeds the amount permitted by the No Surprises Act.
For more information on this new Act visit:
https://www.cms.gov/nosurprises
1. Surprise medical bills are bills from out-of-network providers, air ambulance services and/or facilities to patients that represent the difference between the amount charged by the provider and/or facility and the amount reimbursed by the patient’s health plan. See H.R. 133 – Public Law 116-260, Sec. 102-105.