Fonteum Data GlossaryRegulatory
No Surprises Act: Definition and Healthcare Context
Full name: No Surprises Act (Division BB of Consolidated Appropriations Act, 2021)
The No Surprises Act (Division BB of the Consolidated Appropriations Act, 2021) is a federal law effective January 1, 2022, that protects patients from unexpected out-of-network bills in specified circumstances. The law limits patient cost-sharing to in-network rates for emergency services, air ambulance services, and non-emergency care at in-network facilities when the patient had no informed choice of provider. It also established an independent dispute resolution (IDR) process for payment disputes between insurers and providers.
- Source file
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- Published
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- Retrieved
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- Snapshot
- Not retained for this reference page
- Re-check
- CMS: No Surprises Act overview
- Data as of
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Last updated: 2026-07-11Reviewed by: Dr. Jennifer Montecillo, MD — Gullas College of Medicine, 2019. Non-practicing medical reviewer.
How it’s used
- CMS NPPES NPI Registry: provider NPI is the linking key used in NSA compliance workflows to match billing providers against insurer network directories.
- CMS No Surprises Act compliance data: Fonteum scores NSA compliance from federal IDR filing rates and machine-readable-file data published under the statute.
- 29 CFR §2590.716 and 45 CFR §149.140: the NSA's DOL and HHS implementing regulations define the patient-protection requirements Fonteum's compliance research measures against.
Frequently asked questions
- What does the No Surprises Act do?
- The No Surprises Act prohibits balance billing patients for out-of-network emergency services, air ambulance transport, and unplanned out-of-network care at in-network facilities.
- When did the No Surprises Act take effect?
- The No Surprises Act protections took effect on January 1, 2022.
- What is the IDR process under the No Surprises Act?
- The Independent Dispute Resolution (IDR) process is a federal arbitration mechanism for providers and payers to resolve payment disagreements for NSA-protected services.