No Surprises Act Enforcement Act
Congress Proposes $10,000 Fines for Insurance Companies That Violate Surprise Billing Protections
Stalled
No legislative action in over 90 days.
Legislative Progress
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.
Impact Analysis
Personal Impact
Life & Work
Small businesses that offer group health plans to their employees would benefit from insurers being held more accountable for following surprise billing rules. Higher penalties create stronger incentives for insurance companies to comply, which means small business owners are less likely to deal with complaints from employees about surprise bills, and the overall cost of health plan administration could become more predictable.
Programs
Disabilities
Milestones
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.
Sent to a congressional committee for expert review. The committee decides whether this bill moves forward.
Introduced in House
The bill was officially filed and given a number. It now enters the legislative queue.
Votes
No votes have been recorded for this legislation yet.
Related News
4 articlesThe 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.
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.
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.
Source Information
Document Type
Congressional Bill
Official Title
No Surprises Act Enforcement Act
Data Sources
Sponsor
Cosponsors
(20)Analysis generated by AI. Always verify with official sources.