Federal Policy
Out-of-Network Emergency Spending Declined After No Surprises Act Implementation
Analysis finds out-of-network emergency care spending has fallen since the No Surprises Act took effect in 2022, contrary to debate focused on arbitration costs. The law protects patients from surprise billing for emergency services they cannot choose. For Medicaid managed care plans with emergency coverage obligations, this federal benchmark on balance billing and dispute resolution may inform state approaches to network adequacy and emergency access requirements, particularly where Medicaid enrollees receive emergency care at out-of-network facilities.
Why it mattersThe spending decline demonstrates the No Surprises Act's effectiveness at controlling emergency care costs, potentially providing a model for states addressing Medicaid managed care network adequacy and emergency service payment disputes.