No Surprises Act
The No Surprises Act is a U.S. federal law effective 2022 that protects patients from unexpected out-of-network bills for emergency care and certain non-emergency services at in-network facilities. ASCs must comply with its billing protections and good faith estimate requirements.
What is the No Surprises Act?
The No Surprises Act is a U.S. federal law that took effect in 2022 to protect patients from unexpected out-of-network bills. It generally bars surprise balance billing for emergency services and for certain non-emergency care delivered by out-of-network providers at in-network facilities.
The law also requires that uninsured and self-pay patients receive a good faith estimate of expected charges before scheduled care. In protected situations, patients are responsible only for the cost-sharing they would have owed in-network.
How does the No Surprises Act affect ambulatory surgery centers?
Ambulatory surgery centers must comply with the law's billing protections and its good faith estimate requirements. Because a surgical episode can involve out-of-network anesthesiologists or other providers working at an in-network center, the rules directly shape how and when a patient can be billed.
Compliance affects pre-service workflows, since centers need processes to identify protected services, produce accurate estimates, and avoid prohibited balance bills. Getting this right protects patients and reduces the risk of penalties and disputes.
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