Health

Financial watchdog wants Oregonians to know about new law against surprise medical bills

By Kristian Foden-Vencil (OPB)
Dec. 30, 2021 9:46 p.m.
The Oregon Division of Financial Regulation wants Oregonians to know that starting January 1st they’ll be more protected from surprise medical bills.

The Oregon Division of Financial Regulation wants Oregonians to know that starting January 1st they’ll be more protected from surprise medical bills.

Kristian Foden-Vencil / OPB

The Oregon Division of Financial Regulation wants Oregonians to know that starting Jan. 1 they’ll be more protected from surprise medical bills.

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These bills usually come after someone receives care at an in-network facility, but an out-of-network provider was involved in the care and has charged out-of-network prices.

Under the No Surprises Act, a provider may not bill more than in-network insurance for emergency services — even if the provider is out-of-network.

Mark Peterson with the Oregon Department of Consumer and Business Services said there’s another aspect to the new law Oregonians should know about.

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“Health care providers must provide a good faith estimate for services to anyone who’s uninsured or who self-pays without insurance,” Peterson said.

Consumers who face surprise bills should contact their insurance company first and if it’s not addressed properly, then file a complaint online with the U.S. Department of Health and Human Services or by calling 800-985-3059.

“Make sure to look at your medical bills when you get them,” Peterson said.

The No Surprises Act includes the following protections:

  • Health plans and their facilities/providers must send you a notice of your rights under the law.
  • Insurance companies must keep their provider directories updated. They must limit co-pays, co-insurance, or deductibles to in-network amounts if you rely on inaccurate information in a provider directory.
  • Health care providers must provide a good faith estimate for services to anyone who is uninsured or self-pays without insurance.

The law applies to most health insurance plans, but Medicare and Medicaid have their own protections.

The Oregon Division of Financial Regulation is hosting a No Surprises Act webinar on Wednesday, Jan. 5, from noon to 1 p.m. Staff members from the Centers for Medicare and Medicaid Services will be present to answer questions.

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