The No Surprises Act (effective January 1, 2022) protects patients from unexpected, high medical bills by banning balance billing for most emergency services and certain non-emergency care from out-of-network providers. Patients are only responsible for in-network cost-sharing amounts (copayments, deductibles).

Centers for Medicare & Medicaid Services | CMS (.gov)

Centers for Medicare & Medicaid Services | CMS (.gov)

Key Protections & Rights:

Emergency Services: Prohibits surprise billing for emergency care at out-of-network facilities or from out-of-network providers.

Non-Emergency Care: Prevents out-of-network providers at in-network hospitals from balance billing patients without prior consent.

Air Ambulances: Bans surprise billing for air ambulance services.

Good Faith Estimate (GFE): Uninsured or self-pay patients must receive an estimate of total expected charges (including test, drugs, and equipment) at least one business day before scheduled services. Dispute Process: If a bill is higher than the GFE, patients can initiate a dispute resolution process within 120 days of the bill date. Centers for Medicare & Medicaid Services | CMS (.gov) Centers for Medicare & Medicaid Services | CMS (.gov) What to Do if You Receive a Surprise Bill: If you receive a bill you believe violates this law, you can: Contact the provider/facility to discuss the bill. Contact your insurer to review the claim. File a complaint: Visit CMS.gov/nosurprises or call 1-800-985-3059. Texas Residents: Contact the Texas Department of Insurance for assistance. Centers for Medicare & Medicaid Services | CMS (.gov) Centers for Medicare & Medicaid Services | CMS (.gov)