“Last year in Massachusetts, after finding some lumps in her breast, Jessica Chen went to Lowell General Hospital — Saints Campus, part of Tufts Medicine, for a mammogram and sonogram,” Elisabeth Rosenthal writes over at The Washington Post. “Before the screenings, she asked the hospital for the estimated patient responsibility for the bill using her insurance, Tufts Health Plan. Her portion, she was told, would be $359 — and she paid it. She was more than a little surprised weeks later to receive a bill asking her to pay an additional $1,677.51. … The No Surprises Act, which took effect in 2022, was rightly heralded as a landmark piece of legislation, which ‘protects people covered under group and individual health plans from receiving surprise medical bills,’ according to the Centers for Medicare & Medicaid Services. And yet bills that take patients like Chen by surprise just keep coming. Here’s the problem: While the No Surprises Act has been a phenomenal success in taking on some unfair practices in the Wild West of medical billing, it was hardly a panacea. In fact, the measure protected patients primarily from only one particularly egregious type of surprise bill… When patients unknowingly got out-of-network care at an in-network facility, or when they had no choice but to get out-of-network care in an emergency. … The No Surprises Act also provided some protection from above-estimated bills, but at the moment, the protection is only for uninsured and self-pay patients, so it wouldn’t apply in Chen’s case since she was using health insurance.” Elisabeth Rosenthal, “Surprise medical bills just keep coming,” The Washington Post.