DES MOINES – A new law passed by a bipartisan majority of Congress in 2020, became effective at the beginning of the month. The No Surprises Act, which passed with a bipartisan majority vote in late 2020, protects Americans from most forms of surprise medical bills, including care provided in an emergency and transportation by air ambulances.

Rep. Cindy Axne was one of those who voted for the bill. Axne says “In a medical emergency, no Iowan should be expected to interrupt the care they’re receiving to ensure that their insurance will cover it. That’s why I voted for this commonsense measure that will protect the one in every five emergency room visitors that are left with astronomical medical bills that they never expected to receive.

The law prevents patients from receiving a surprise medical bill from an out-of-network health provider after:

• receiving emergency care in an emergency room
• receiving any care at an in-network health care provider
• being transported by an air ambulance (airplane or helicopter) to receive additional medical care

Prior to this measure’s passage, Rep. Axne’s office says she successfully pushed congressional leaders to include language to cover surprise bills for air ambulance trips, which are often the only viable emergency transportation available for rural Americans. “In rural parts of Iowa,” she says, “a serious or life-threatening injury can require air ambulances that leave Iowans on the hook for tens of thousands of dollars to get to their nearest hospital – which can sometimes be more than 50 miles away. These trips aren’t a choice. There aren’t alternative arrangements that can save a patient money. These trips are sometimes a life-or-death journey – and yet still they’re causing astronomical bills for my constituents.” “This new law,” she says, “protects them and the thousands of others a year that will need an air ambulance trip to help them in crisis.”

Additional Background:

• Studies estimate that one of every five emergency rooms visits generates surprise medical bills when insured consumers inadvertently receive care from out-of-network hospitals, doctors, or other providers they did not choose.
• The new law applies to hospitals, hospital outpatient services, emergency rooms, urgent care centers, but not to non-emergency services provided at facilities that are unlicensed to provide emergency services (e.g., addiction treatment facilities).
• While the No Surprises Act does not cover ground ambulance trips, Rep. Axne previously fought to ensure emergency medical services (EMS) personnel could receive Medicare reimbursement for care they deliver to patients on scene.

The Treatment in Place Act ensures medical care provided by ground ambulance crews at the site of an emergency are reimbursed even if the patient is not ultimately taken to a hospital. That measure was signed into law in March 2020.