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