No Surprises Act Enforcement Act

This bill strengthens the rules that ban surprise medical bills. It raises fines on health plans, insurers, and out-of-network providers who break these rules. It also adds tough penalties if either side pays late after an independent dispute decision. If a required payment isn’t made on time, the late payer must cover the amount owed plus an extra charge equal to three times the gap between the first payment (or $0 if denied) and the allowed out-of-network rate, and pay interest as well. These rules apply to emergency care, nonemergency care, and air ambulance services . The bill also lets the government fine group health plans up to $10,000 per violation for certain failures to follow these protections .

The bill requires regular public reporting so people can see how well the law is being enforced. Every six months after it becomes law, federal agencies must report the number of audits, complaints, enforcement actions, total fines, and the most common types of violations .

• Who is affected: Patients, health plans and insurers, out-of-network doctors and facilities, and air ambulance providers .
• What changes: Higher fines for breaking surprise billing rules; triple-difference late payment penalties with interest; more frequent transparency reports on audits and enforcement .
• When: Semiannual enforcement reports begin after the law takes effect .