Health Insurance State Laws:
No Surprises Act

This chart indicates whether the federal or state process is used by each state for disputes related to medical billing under the federal No Surprises Act. Note that some states used a mixed system where the system used depends on the type of complaint. Use the links in the chart to be directed to the complaint system chosen by your state for consumer complaints. Check back often, as this chart is updated frequently.

If you have a self-funded plan, certain state laws may not apply. For information on how to determine if your plan is self-funded, see our blog post.

If you don't find what you're looking for, see our other Charts of Health Insurance State Laws:

For more health insurance information, visit our Health Insurance Materials & Resources. If you are looking for information on Medicare or Medicaid, return to the main state laws page.

StateSurprise Billing Resolution Process (Federal/State/Mixed)
AlabamaFederalhttps://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
AlaskaStatehttps://www.commerce.alaska.gov/web/ins/ProviderComplaints.aspx
ArizonaFederalhttps://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
ArkansasFederalhttps://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
CaliforniaMixedhttps://www.insurance.ca.gov/01-consumers/110-health/60-resources/NoSupriseBills.cfm
ColoradoMixedhttps://doi.colorado.gov/insurance-products/health-insurance/health-insurance-initiatives/federal-no-surprises-act/colorado
ConnecticutMixedhttps://portal.ct.gov/CID/General-Consumer-Information/State-Surprises-Act
DelawareMixedhttps://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
District of ColumbiaFederalhttps://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
FloridaMixedhttps://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
GeorgiaStatehttps://oci.georgia.gov/document/bulletin/bulletin-21-ex-10-surprise-billing-arbitration-application-form/download
HawaiiFederalhttps://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
IdahoFederalhttps://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
IllinoisMixedhttps://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
IndianaFederalhttps://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
IowaFederalhttps://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
KansasFederalhttps://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
KentuckyFederalhttps://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
LouisianaFederalhttps://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
MaineStatehttps://dispute.maximus.com/me/indexME
MarylandMixedhttps://www.marylandattorneygeneral.gov/Pages/CPD/HEAU/NSA.aspx#1
MassachusettsFederalhttps://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
MichiganStatehttps://www.michigan.gov/mdcs/employeebenefits/insurance-info/data/federal-State-surprises-act
MinnesotaFederalhttps://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
MississippiFederalhttps://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
MissouriMixedhttps://insurance.mo.gov/consumers/health/no-surprises-act.php
MontanaFederalhttps://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
NebraskaMixedhttps://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
NevadaMixedhttps://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
New HampshireMixedhttps://www.nh.gov/insurance/consumers/documents/balance_billing_surprise_billing.pdf
New JerseyMixedhttps://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
New MexicoMixedhttps://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
New YorkMixedhttps://www.dfs.ny.gov/IDR
North CarolinaFederalhttps://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
North DakotaFederalhttps://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
OhioMixedhttps://insurance.ohio.gov/consumers/surprise-billing/resources/01-surprise-billing
OklahomaFederalhttps://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
OregonFederalhttps://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
PennsylvaniaFederalhttps://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
Puerto RicoFederalhttps://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
Rhode IslandFederalhttps://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
South CarolinaFederalhttps://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
South DakotaFederalhttps://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
TennesseeFederalhttps://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
TexasStatehttps://www.tdi.texas.gov/medical-billing/surprise-balance-billing.html
UtahFederalhttps://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
VermontFederalhttps://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
VirginiaMixedhttps://scc.virginia.gov/pages/Balance-Billing-Protection
WashingtonMixedhttps://www.insurance.wa.gov/what-consumers-need-know-about-surprise-or-balance-billing
West VirginiaFederalhttps://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
WisconsinFederalhttps://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
WyomingFederalhttps://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
U.S. Territories
American SamoaFederalhttps://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
GuamFederalhttps://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
North Mariana IslandsFederalhttps://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
Puerto RicoFederalhttps://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
U.S. Virgin IslandsFederalhttps://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
Last Updated1/2023