Last Updated: September 2026
State-by-state survey of balance billing laws, surprise billing protections, dispute resolution, disclosures, and patient safeguards.
This state-by-state legal survey summarizes balance billing and surprise medical billing protections across the United States, distinguishing between states that have adopted comprehensive approaches to balance billing and those that have taken a more piecemeal approach, using a framework based on a Commonwealth Fund study. It outlines how states regulate emergency and non-emergency out-of-network services, patient cost-sharing protections, disclosure requirements, dispute resolution and arbitration processes, carrier and provider obligations, and the interaction between state laws and self-funded employer health plans under ERISA. The survey also tracks recent legislative, regulatory, and administrative updates affecting balance billing protections nationwide, including a newly included Oregon administrative rule effective June 29, 2026.
