The No Surprises Act establishes patient protections against surprise medical bills and includes several transparency and other provisions.
- Health Insurance Requirements for coverage of emergency services regardless of network and
for non-emergency services performed by out-of-network providers at in-network facilities in certain circumstances.
- Establishes guidelines for determining of out-of-network rates to be paid by health plans in the
above instances and an independent dispute resolution (IDR) process.
- Prohibits out-of-network providers from balance billing patients for covered emergency services
or certain covered non-emergency services provided at in-network facilities unless certain conditions are met.
- Requires both health plans and providers to assist patients in accessing health care cost
information. (Advanced EOB and online price comparison tool)
- Ensures continuity of care when there is a change in the plans’ provider network in
- Requires health plans to maintain an online price comparison tool.
As of July 1, 2022, Kern County will be utilizing Anthem at
https://www.anthem.com/ca/machine-readable-file/search to provide
Price transparency reports for the Kern Legacy Max Choice and
Kern Legacy Classic Choice Health Plans.
No Surprises Act Notice (PDF)