Surprise Medical Bills: Your Rights Under the No Surprises Act

What is a surprise medical bill?

A surprise medical bill occurs when you receive care from an out-of-network provider without your knowledge or consent — most commonly when you go to an in-network hospital but are treated by an out-of-network specialist such as an anesthesiologist, radiologist, or emergency physician. Before federal protections were enacted, patients could receive bills for tens of thousands of dollars in these situations.

The No Surprises Act

The No Surprises Act, which took effect January 1, 2022, provides significant federal protections against surprise bills. Under this law, for most emergency services and certain non-emergency services at in-network facilities, you cannot be charged more than your in-network cost-sharing amount — even if the provider is out-of-network.

What is covered

The No Surprises Act covers: emergency services at any facility regardless of network status; non-emergency services at in-network facilities when you did not have a meaningful choice of provider (such as anesthesiology or radiology); and air ambulance services from participating providers.

What is not covered

The law does not cover: ground ambulance services (a significant gap); out-of-network care you knowingly chose; and situations where you signed a valid consent form agreeing to out-of-network charges at least 72 hours before a scheduled service.

How to dispute a surprise bill

If you receive a bill you believe violates the No Surprises Act, first contact your insurer to confirm the service should be covered under the law. If the insurer agrees but the provider continues to bill you, file a complaint at cms.gov/nosurprises. You can also use the federal independent dispute resolution process if you and the provider cannot agree on a payment amount.