Federal No Surprises Act prohibits ‘surprise billing’

Blue Cross Blue Shield of Michigan and Blue Care Network have made changes to align with the federal No Surprises Act, effective Jan. 1, 2022. The law, part of the Consolidated Appropriations Act, or CAA, prohibits surprise billing nationwide for emergency, some non-emergency and air ambulance services.  

Surprise billing is when a member unknowingly receives care from a health care provider who doesn’t participate with the member’s health insurance plan. The member then receives an unexpected bill for the difference between the health plan’s payment and what the health care provider charges. 

Blue Cross and BCN already align with the state surprise billing law, which went into effect Oct. 22, 2020. The state law prohibits surprise billing by Michigan nonparticipating professional providers for emergency services and some non-emergency services.  

As of Jan, 1, 2022, Blue Cross is handling claims according to the federal law for self-funded ERISA plans, grandfathered plans and federal health plans. We’re also following the federal law for fully insured plans and self-funded state or local government plans. However, these plans will still follow the state law for professional provider payment rates and arbitration procedures.  

Blue Cross maintains the broadest network of providers in Michigan, and helps ensure access to high-quality, in-network care across the country through our relationship with the Blue Cross Blue Shield Association. 

If you have questions, contact Provider Inquiry at the appropriate number below:

• Blue Cross Blue Shield of Michigan
• Michigan physicians and other professional providers of care: 1-800-344-8525
• Providers outside of Michigan: 1-800-676-2583
• Michigan hospital and facility providers: 1-800-249-5103
• Hospital and facility providers outside of Michigan: 1-800-676-2583

• Blue Care Network
• Professional providers: 1-800-344-8525
• Ancillary and facility providers:1-800-249-5103