State Prepares for Federal No Surprises Act Implementation

June 9, 2021

The Washington State Office of the Insurance Commissioner (OIC) and the State Department of Health (DOH) have begun work with stakeholders to assess what is needed to implement the federal No Surprises Act (NSA) passed by Congress in December.  This could take the form of legislation or rulemaking. The NSA is conceptually similar to Washington’s existing Balance Billing Protection Act (BBPA), but there are significant differences in scope, details, and enforcement between the two laws to be addressed and it unclear exactly how the two laws will interact. WSHA was actively involved in the passage and implementation of the BBPA and will be working with our member hospitals, state and federal agencies and stakeholders to ensure the NSA provides sufficient protections for consumers, hospitals, and providers and to the degree possible, avoids excessive administrative burden or duplication.

OIC has convened stakeholder groups representing providers, hospitals, consumers, carriers and purchasers for input. A summary of the input received is here. A technical workgroup of insurer, provider, and hospital subject matter experts is also being formed to address uniform modes of communications and information transactions between insurers, hospitals, and providers to address requirements under the NSA.

Many details regarding the specific requirements and monitoring and enforcement structures under the NSA will not be known until federal rulemaking is completed.  More work will be done in the coming months as more details are known. (Andrew Busz,


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