No Surprises Act Enforcement Act

Increased penalties for balance billing violations: The bill increases penalties to $10,000 for certain failures regarding balance billing provisions (Section 2, subsections a, b, and c). This could provide stronger enforcement against practices that violate billing requirements.

Penalties for late or non-payment of determined amounts: The bill creates a penalty that is three times the difference between the initial payment and the out-of-network rate for those that fail to make required payments within 30 days (Section 3, subsections a, b, and c). This is intended to ensure that payments following a determination are made in a timely manner.

Enhanced transparency through reporting: The Secretary is required to submit reports to Congress every six months regarding the number of audits conducted, complaints submitted by providers or beneficiaries, and the total amount of civil monetary penalties issued (Section 4, subsections a and b). This provides oversight on how enforcement actions are being handled.

Financial penalties for health plans and issuers: The bill imposes significant civil penalties, including amounts up to $10,000 for each individual in the case of certain non-compliance (Section 2, subsection b).

Increased costs due to late payment penalties: Plans, coverage, or providers that fail to make required payments within 30 days must pay an amount that is three times the difference between the initial payment and the out-of-network rate, plus interest (Section 3, subsections a, b, and c).