Federal Agencies Move Forward with “Surprise Billing” Regulations that will Impact Moms

By Shalini Wickramatilake, MHS

In December 2020, the No Surprises Act was signed into law as part of the fiscal year 2021 appropriations package. This Act aims to protect patients from “surprise” medical bills, which are unexpected bills that individuals may receive after receiving healthcare services. In July 2021, in an effort to start implementing the No Surprises Act, the Department of Health and Human Services (HHS), Department of Labor (DoL), Department of the Treasury, and the Office of Personnel Management (OPM) issued a regulation to restrict excessive out-of-pocket costs from surprise billing. This rule goes into effect for health care providers and facilities, as well as group health plans, health insurance issuers, and Federal Employees Health Benefits (FEHB) program carriers on January 1, 2022.

On September 30, 2021, federal agencies issued a second part to their No Surprises Act rulemaking process. The September 2021 rule attempts to further strengthen implementation of the No Surprises Act through a variety of technical changes to the processes used for billing and reducing the opportunity for non-contracted providers to dispute what they believe to be low payments.

While it’s critical that providers be reimbursed at fair rates when contracting with insurers we believe that mothers and families shouldn’t be caught in the middle.

Implementation of the No Surprises Act is crucial for reducing financial stressors on mothers during pregnancy and the postpartum period. A study published earlier this year found that 1 in 5 parents will receive a surprise medical bill following childbirth (Chua, Fendrick, and Conti, 2021). According to the same study, the cost of these surprise bills tend to range from $138 to over $10,000. These unexpected bills from prenatal, delivery, and postnatal medical services can serve as major burdens for moms during a time that is already filled with stress and uncertainty. Several studies have found that financial stress has an impact on mental health (Marcil et al, 2020; Cameron et al, 2020; Davenport et al, 2020). It is crucial that surprise billing is restricted so that moms are not faced with additional financial stressors during a time when they are already especially vulnerable to mental health struggles.

2020 Mom applauds passage of the No Surprises Act and the recent steps taken by the government to implement the restriction of surprise medical bills for all individuals, including moms and their families, beginning in 2022.