Federal Rule to Prevent Surprise Health Care Billing

NASW Social Work Blog

Application to Clinical Social Work Services

Under a new federal rule to protect consumers from surprise health care bills, clinical social workers (CSW) and other health care provider types must, effective January 1, 2022, provide a good faith estimate (GFE) of expected charges that may be billed for items and services to individuals who are uninsured (e.g., not enrolled in any health plan or coverage) or who are self-pay (e.g., not seeking to file a claim with their plan or coverage). The GFE must be provided both orally and in writing, upon request or at the time of scheduling health care items and services, and within specific timeframes.

The rule applies to both current and future patients who are uninsured or self-pay. However, GFEs do not need to be provided to patients who are enrolled in federal health insurance plans (e.g., Medicare, Medicaid, TRICARE, Indian Health Service or the Veterans Affairs health system).

Providing a GFE to patients is not new to CSWs who, as part of best clinical practice, routinely discuss services and fees before or during the initial interview with new patients.

Review NASW's Resources on the New Regulation: https://www.socialworkers.org/Practice/Clinical-Social-Work/No-Surprises-Act-Regulations-2022?_zs=3bkug1&_zl=B9x78

NASW members only: For further conversation about the federal rule, see this active thread on the national MyNASW board.