Understanding the No Surprises Act & the Role of MLPs in Helping Patients

By The National Center for Medical-Legal Partnership

The No Surprises Act (NSA) was enacted to help protect patients from surprise, out-of-network medical bills. However, given a short turnaround between when the bill was enacted in 2020 and when it went into effect earlier this year, there has been considerable confusion over the Act and its implications on both patients and providers.

On May 9, attendees heard from medical-legal partnership practitioners from the Georgetown University Health Justice Alliance and Whitman-Walker Health as well as representatives from CMS/CCIIO as they helped us to understand the NSA; how MLPs play a unique role in helping patients to navigate complex systems for care, coverage, and payment; and where MLP practitioners can find information and resources for their patients, providers, and advocates.

Speakers Included:

Jeananne Sciabarra, Division of Consumer Advocacy and Assister Support, CMS/CCIIO
Sarah Barber, Director, Division of Consumer Advocacy and Assister Support, CMS/CCIIO
Patrick Edwards, Director, Division of Consumer Services, CMS/CCIIO
Sam Schaffzin, Compliance and Enforcement Division, CMS/CCIIO
Kei Helm, Market-wide Regulation Division, CMS/CCIIO
Janny Frimpong, Division of Consumer Advocacy and Assister Support, CMS/CCIIO
Erin Loubier, Senior Director for Health and Legal Integration & Payment Innovation, Whitman-Walker Health
Allison Dowling, MLP Director of the Cancer Legal Assistance and Wellbeing (LAW) Project, Georgetown University Health Justice Alliance


The following resources were shared before and during the event.

In Health Affairs:

Recent Guidance To Implement The No Surprises Act, Katie Keith, Jack Hoadley, and Kevin Lucia, Health Affairs, February 18, 2022 

From CMS:

The No Surprises Act: An Overview for Assisters, Advocates, Agents and Brokers (YouTube)
Understanding Good Faith Estimates & Patient Provider Dispute Resolution for Assisters & Advocates (YouTube)
CMS No Surprises Act Website
CAA/NSA Enforcement Letters
Some Provider Requirements & Resources
Complaints about medical billing