No Surprises Act Enforcement Act
Summary
The No Surprises Act Enforcement Act aims to strengthen the enforcement of balance billing requirements under the No Surprises Act. It increases penalties for group health plans and health insurance issuers that violate these requirements. The bill also introduces additional penalties for late or non-payment after an Independent Dispute Resolution (IDR) entity makes a payment determination.
Expected Effects
The Act will likely lead to stricter compliance with balance billing rules by health plans and insurers due to increased financial penalties. This could reduce surprise medical bills for patients. The increased transparency in reporting will provide better oversight and accountability.
Potential Benefits
- Reduces surprise medical bills for patients.
- Increases compliance with balance billing requirements.
- Provides more transparency through enhanced reporting requirements.
- Ensures timely payments after IDR determinations.
- Strengthens consumer protections against unfair billing practices.
Potential Disadvantages
- Increased costs for health plans and insurers could potentially lead to higher premiums.
- More complex administrative processes for compliance.
- Potential for disputes over payment determinations and penalties.
- Increased regulatory burden on healthcare providers and facilities.
- Possible unintended consequences related to provider network participation.
Constitutional Alignment
The bill appears to align with the Constitution's broad goals of promoting the general welfare (Preamble). Congress has the power to regulate interstate commerce, which includes health insurance and healthcare markets (Article I, Section 8, Clause 3). The increased penalties and reporting requirements do not appear to infringe on individual liberties or rights explicitly protected by the Constitution.
Impact Assessment: Things You Care About ⓘ
This action has been evaluated across 19 key areas that matter to you. Scores range from 1 (highly disadvantageous) to 5 (highly beneficial).