No Surprises Act Enforcement Act
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Progress
Where this bill stands in the legislative process.
- Introduced
- Passed Senate
- Passed House
- To President
- Became Law
Overview
The No Surprises Act Enforcement Act aims to strengthen penalties for group health plans, health insurance issuers, and nonparticipating providers regarding balance billing violations. Specifically, it increases financial penalties for non-compliance, enhances transparency reporting requirements, and clarifies enforcement procedures related to late payments or non-payments. The bill seeks to ensure that patients are not unexpectedly billed for out-of-network care and to hold accountable those who violate the No Surprises Act.
Key provisions
- Increases financial penalties for group health plans and issuers for balance billing violations to $10,000 per violation.
- Raises penalties for late payment or non-payment of medical bills to three times the initial payment amount.
- Requires annual reporting to Congress on audits and enforcement actions related to the No Surprises Act.
- Expands the scope of reporting to include details on complaints, penalties issued, and common violations.
- Clarifies the timing and notification requirements for payment determinations.
- Modifies the Public Health Service Act and ERISA to align with the increased penalty amounts.
- Updates the Internal Revenue Code to reflect the enhanced penalties.
- Introduces transparency reporting requirements regarding audits and enforcement actions.
Who is affected
- Group health plans
- Health insurance issuers
Bill text
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