National News

New No Surprise Billing Regulations for Behavioral Health Care Providers

Dec 22, 2021
The No Surprises Act aims to increase price transparency and reduce the likelihood that clients receive a “surprise” medical bill by requiring that providers inform clients of an expected charge for a service before the service is provided.

 

Starting January 1, 2022, behavioral health care providers will be required by law to give uninsured and self-pay clients a good faith estimate of costs for services when scheduling care or when the client requests an estimate.

The No Surprises Act aims to increase price transparency and reduce the likelihood that clients receive a “surprise” medical bill by requiring that providers inform clients of an expected charge for a service before the service is provided. The government will also soon issue regulations requiring behavioral health providers to give similar good faith estimates to commercial or government insurers, when the client plans to use medical insurance.

Consumers will also have new billing protections when getting emergency care, non-emergency care from out-of-network providers at in-network facilities, and air ambulance services from out-of-network providers. Through new rules aimed to protect consumers, excessive out-of-pocket costs will be restricted, and emergency services must continue to be covered without any prior authorization, and regardless of whether or not a provider or facility is in-network.

This new requirement was finalized on October 7, 2021. These regulations implement part of the “No Surprises Act,” originally enacted in December 2020 as part of a broad package of COVID-19 and spending-related legislation. This consumer protection legislation is aligned with professional counseling ethics regarding our duty to promote client welfare and protect against potential harm. The ACA Code of Ethics (Section A.2.b) stipulates that counselor must inform their clients about fees and billing practices.

ACA recently head a Town Hall event on the No Surprises Act. You can find a recording of it HERE.

To learn more about the No Surprise Act or to become involved in ACA’s advocacy efforts, please go to [email protected] for more information.

Below are a few resources from ACA.

ACA Support Access to Mental Health Services for Seniors

ACA Medicare MH Coverage Gap-Executive Summary DRAFT

How to Advocate.pdf

SDCA, SDSCA, and SDMHCA is not always at liberty to take a stance on all issues, we do encourage our members (and really all citizens) to become informed and to share their viewpoints with their elected officials. We encourage you to take part of any open forums in your areas as well, as this is a great way to be heard on a local level.

Please see the following links for contact information as well as tips for reaching out to senators and representatives. 

We sincerely thank you for your advocacy efforts.
SDCA Executive Committee

For current national issues and what you can do to help go to: https://www.counseling.org/government-affairs/public-policy. This is available to ACA members and non-members alike. Check out information regarding:

  • Medicare Coverage of LPCs.
  • Mental Health Providers in the VA.
  • Reducing student to counselor ratios through the Student Support Act.

For information about the US Congress and the national legislative process, go to Congress.gov at http://beta.congress.gov/ and find out how:

  • To search bills by topic, bill number, or title.
  • To locate updated contact information for our Senators and Representatives.

Please feel free to contact your Government Relations Committee with questions or concerns.