Evaluation of the Impact of the No Surprises Act on Health Care Market Outcomes: Baseline Trends and Framework for Analysis – First Annual Report to Congress. 45 pages.

“The Assistant Secretary for Planning and Evaluation (ASPE) advises the Secretary of the U.S. Department of Health and Human Services (HHS) on policy development in health, disability, human services, data, and science; and provides advice and analysis on economic policy. ASPE leads special initiatives; coordinates the Department’s evaluation, research, and demonstration activities; and manages cross – Department planning activities such as strategic planning, legislative planning, and review of regulations. Integral to this role, ASPE conducts research and evaluation studies; develops policy analyses; and estimates the cost and benefits of policy alternatives under consideration by the Department or Congress….

“The No Surprises Act (NSA) was enacted on December 27, 2020, to address certain instances of surprise billing – circumstances where individuals with private health plans and coverage receive unexpectedly high medical bills when they are unknowingly or unavoidably treated by an out-of-network (OON) provider, facility, or provider of air ambulance services. Under the law, an OON provider subject to balance billing requirements generally may not charge more than the patient’s in-network cost sharing requirement based on the Recognized Amount for non-air ambulance items and services. The law also creates a process for resolving disputes over payment rates between providers and plans and issuers under certain circumstances. The enactment of NSA, as well as several previous state surprise billing laws, was motivated by consumer concerns about the adverse financial impacts of surprise medical bills. Section 109 of NSA requires the Secretary, in consultation with the Federal Trade Commission and Attorney General, to produce five annual reports on the impact of NSA on patterns of vertical or horizontal integration, overall health care costs, and access to health care items and services. This is the first of those reports.”

This document is accessible online at: https://aspe.hhs.gov/sites/default/files/documents/48b874b63796dc6a68a783cf079ba42a/aspe-no-surprises-act-rtc.pdf

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