NO SUPRISES ACT: PROVIDING A PRICE COMPARISON TOOL FOR HEALTHCARE CONSUMERS

No Surprises Act: Providing a Price Comparison Tool for Healthcare Consumers

As a result of the No Surprises Act, group health plans and insurers must offer a price comparison tool that healthcare consumers can access via the Internet or by telephone. The new law is part of the Consolidated Appropriations Act, 2021, which was enacted in December 2020. The requirement becomes effective for plan years beginning on or after Jan. 1, 2022.

The Price Comparison Tool
According to the new law, a group health plan or a health insurer must establish and maintain price comparison guidance by telephone and via the plan or insurer’s website. The price comparison tool will allow participants to compare their cost-sharing responsibility for a specific healthcare service among participating providers in a particular geographic region during the plan year.

Applicability
The mandate applies to ERISA and non-ERISA (non-federal governmental, and church plans) self-funded groups health plans and fully insured group and individual insurers.