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Congress·In Committee·7 months ago

Congress Proposes $10,000 Fines for Insurance Companies That Violate Surprise Billing Protections

Also known as: No Surprises Act Enforcement Act

Legislative Progress

✓ Filed
Review
House
Senate
President

Impact Analysis

Scores: 1 = low, 5 = highSentiment: -5 to +5 (net benefit)

Key Points

  • This bill increases the fines that health insurance companies must pay if they break laws protecting patients from surprise medical bills. Currently, companies might only pay $100 a day for certain mistakes, but this plan would raise that to $10,000 for every single violation.
  • It targets 'balance billing,' which happens when a patient gets an unexpected bill from an out-of-network doctor even though they went to an in-network hospital. The goal is to make sure insurance companies follow the federal rules that protect patients from these high costs.
  • If an insurance company and a doctor have a dispute over a bill that goes to a neutral tie-breaker, the loser must pay within 30 days. If they fail to pay on time, they would be forced to pay three times the original amount owed, plus interest.
  • The bill requires the government to track and report these violations more closely. Every six months, officials would have to tell Congress how many audits they performed, how many complaints they received from patients, and which companies were fined.
  • By making the penalties much more expensive, the bill aims to stop insurance companies from ignoring the law or delaying payments to doctors. This is intended to ensure that the existing protections for patients are actually enforced.
Healthcare

Milestones

2 milestones2 actions
Jul 23, 2025House

Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and Workforce, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

Jul 23, 2025

Introduced in House

Related News

4 articles
The Washington Post·8 months ago

The surprise medical bills just keep coming

Despite the 2022 landmark law, patients still face unexpected charges due to enforcement gaps. The article highlights how insurers and providers exploit loopholes, which the No Surprises Act Enforcement Act specifically aims to close by increasing penalties and mandates.

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Becker's Hospital Review·about 1 year ago

Senators introduce bill to close No Surprises Act's 'enforcement gap'

Senators Marshall and Bennet introduced the No Surprises Act Enforcement Act to bolster the 2020 law. The bill proposes increasing penalties for noncompliance with payment deadlines and creating parity between penalties for insurers and providers.

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Radiology Business·7 months ago

Lawmakers seek to penalize payers that refuse to reimburse radiology claims under NSA

Bipartisan members of the House and Senate officially introduced the No Surprises Act Enforcement Act in July 2025. The legislation targets 'big insurance companies' that have allegedly willfully defied the law by refusing to pay arbitration awards within the 30-day statutory period.

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Source Information

Document Type

Congressional Bill

Official Title

No Surprises Act Enforcement Act

Bill NumberHR 4710
Congress119th Congress
ChamberHouse of Representatives
Latest ActionReferred to the Committee on Energy and Commerce, and in addition to the Committees on Education and Workforce, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

Sponsor

Cosponsors

(20)
D: 10R: 10

Analysis generated by AI. While we strive for accuracy, this should not be considered legal or professional advice. Always verify information with official government sources.