Federal legislation often includes provisions that lead to unintended consequences. One such provision in the Patient Protection and Affordable Care Act (the “Act”) likely has left some hospital benefits managers scratching their heads: a requirement that certain group health plans may not impose greater restrictions on out-of-network emergency care services (Section 10101(h) of the Act).)
Specifically, under the Act, starting in 2011, non-grandfathered plans must provide coverage for emergency services without regard to whether the provider is in-network or out-of-network.