Insurance and Fees

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No Surprise Act 2022

In short, as of January 1, under federal law behavioral health care providers are 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 U.S. Centers for Medicare & Medicaid Services (CMS) has published information regarding the federal No Surprises Act. You can find more specific information on the CMS website: No Surprises Act | CMS.

The State of Ohio also has related law relating to surprise billing that went into effect on January 12, 2022. Generally, Ohio’s law prohibits any unanticipated out-of-network care in emergency care situations or when an individual does not have the ability to choose. More information about Ohio’s law is available on the Ohio Department of Insurance (ODI) website: Surprise Billing | Department of Insurance.

In addition to the information available from ODI and CMS, industry associations have also provided helpful resources:

• AAMFT – https://aamft.org/AAMFT/ENHANCE_Knowledge/Copy_of_No_Surprises_Act/enhance_knowledge/No_Surprises_Act.aspx?hkey=8f621276-92a9-4c9a-9c38-14d7e396562d
• NASW - http://www.socialworkblog.org/practice-and-professional-development/2021/12/federal-rule-to-prevent-surprise-health-care-billing/
• ACA - https://www.counseling.org/news/updates/news-detail/2021/12/22/new-no-surprise-billing-regulations-for-behavioral-health-care-providers
• NBCC - https://www.nbcc.org/govtaffairs/newsroom/no-surprises-act