State or Federal Law or Regulation Related to Patient Safety
The No Surprises Act (NSA) which was signed into law as part of the Consolidated Appropriations Act of 2021 and took effect on January 1, 2022, aims at protecting patients from surprise medical bills especially for out of network emergency services, air ambulance services as well as when a patient is receiving a service from an out of network provider in an in-network facility (Hirsch et al., 2022). This law requires that healthcare organizations inform patients of approximate charges for services not in an emergency and create an independent method of dealing with payment disputes. Therefore, hospitals and providers must attend to patients. If the federal transparency laws are followed, patients would not be able to be charged with many other costs they never expected.

Changes Resulting from the Law or Regulation
The No Surprises Act has introduced many changes in the activities of healthcare facilities. These rules require that hospitals and providers have adequate billing transparency, patient cost disclosure, and bans on balance billing for out-of-network services. In addition, there are also changes in the administrative procedures to allow independent ways of handling disagreements between the provider and the insurer through arbitration (Lieneck et al., 2023). These requirements have increased the administrative costs because of the need for better training, legal advice, and changes in billing systems. Overall, all these changes aim at improving the financial stability of the patient and reducing cases of billing surprises.

Technology Associated with the Law or a Similar Regulation
This law has led healthcare organizations to invest more in improved billing and pricing transparency technologies. Some of them are price estimating services, auto billing features, and EHR interfaces for cost estimating and billing. Additionally, using the digital patient portals, people can easily get reasonable estimates, check their insurance coverage, and dispute wrong billing (Oldeweme et al., 2021). These technologies assist in the achievement of regulatory requirements while at the same time enhancing the flow of communication regarding financial matters between providers, insurers, and patients. However, these systems are expensive and require technical support to run efficiently.

Ethical Dilemmas Resulting from Technology Changes in Patient Safety
As much as the use of technology improves patient safety, some ethical concerns come with the advancement in technology. One such challenge is data privacy and security since patients’ financial and health information is in electronic form and can easily be breached or accessed by unauthorized persons (Grossberg et al., 2024). Secondly, automated billing systems may generate wrong estimations that may put financial pressure on the patients who rely on such estimations to make their medical decisions. Furthermore, overreliance on technology increases the likelihood of the growth of health disparities between the populations that are not literate in the use of technology and the internet and other populations that have better access to these facilities in the long run (Grossberg et al., 2024). These ethical issues demonstrate the need to balance the use of technology in healthcare and the provision of patient-centered care.

Addressing Ethical Issues of Technology in the Safety of Patients
Addressing these ethical issues requires the need for legislation, the enhancement of existing technology, and the representation of the needy groups. Effective measures include increasing the security of the networks, ensuring that the organization complies with the HIPAA standards, and conducting risk assessments from time to time to mitigate the risk of privacy (Mensah et al., 2024). Algorithmic transparency should be increased through human supervision over the developed algorithms in the automated billing system, which will help minimize patient losses. It is also important to prevent inequality in the availability of information by offering patient education programs and choices, including those that are not electronic, such as paper cost estimates and telephone-based financial counseling to underserved populations (Mensah et al., 2024). All these strategies promote ethical patient-centered care and support the use of technology.
 
References
Grossberg, J. A., Heller, R. E., Niknejad, K. G., Milburn, J. M., & Hirsch, J. A. (2024). No Surprises Act—what neurointerventionalists need to know. Journal of NeuroInterventional Surgery, 16(7), 640-643. https://jnis.bmj.com/content/16/7/640.abstractLinks to an external site.

Hirsch, J. A., Buch, K., Keysor, K., Mehan, W. A., & Milburn, J. M. (2024). No Surprises Act: legal challenges and implications for radiology. Journal of the American College of Radiology, 21(4), 651-655. https://www.sciencedirect.com/science/article/pii/S1546144023008438Links to an external site.

Lieneck, C., Gallegos, M., Ebner, M., Drake, H., Mole, E., & Lucio, K. (2023, March). Rapid review of “No surprise” medical billing in the United States: Stakeholder perceptions and challenges. In Healthcare (Vol. 11, No. 5, p. 761). MDPI. https://www.mdpi.com/2227-9032/11/5/761Links to an external site.

Mensah, N. K., Adzakpah, G., Kissi, J., Taylor-Abdulai, H., Johnson, S. B., Agbeshie, P. A., … & Boadu, R. O. (2024). Health Professionals’ Ethical, Security, and Patient Safety Concerns Using Digital Health Technologies: A Mixed Method Research Study. Health Services Insights, 17, 11786329241303379. https://journals.sagepub.com/doi/abs/10.1177/11786329241303379Links to an external site.

Oldeweme, A., Märtins, J., Westmattelmann, D., & Schewe, G. (2021). The role of transparency, trust, and social influence on uncertainty reduction in times of pandemics: empirical study on the adoption of COVID-19 tracing apps. Journal of medical Internet research, 23(2), e25893. https://www.jmir.org/2021/2/e25893/