No Surprises Act

The No Surprises Act (NSA) is a federal law designed to protect patients from unexpected medical bills arising from certain healthcare services furnished by out-of-network providers. Effective January 1, 2022, the NSA prohibits providers from balance billing for services furnished at out-of-network emergency facilities and for certain non-emergency services provided by out-of-network providers at in-network facilities. Under the NSA, insurers make an initial payment to the healthcare provider, which can choose to use an independent dispute resolution (IDR) process to resolve payment disputes with insurers.

Sidley provides the following services:

• Advise on compliance with the NSA
• Represent stakeholders in lawsuits challenging regulations implementing the NSA
• Represent stakeholders in CMS inquiries into potential violations of the NSA
• Advise on operationalizing good faith estimate requirements

The regulatory landscape around the NSA has repeatedly shifted since the law went into effect as a result of successful legal challenges. This resource page includes Sidley insights on NSA implementation, as well as NSA regulations, guidance, and court decisions.