No Surprises Act

1. Federal Protections Under the No Surprises Act
Under Sections 2799B–1 and 2799B–2 of the Public Health Service Act and implementing regulations (45 CFR § 149.410–.420 and § 149.430), providers and facilities cannot bill you more than your in-network cost-sharing (copays, coinsurance, deductibles) when you receive certain services, including:

  • Emergency care from an out-of-network provider or facility.

  • Non-emergency services furnished by out-of-network providers at in-network facilities.

2. State Law Protections
Colorado law may further limit what providers can charge you when they do not have a contract with your insurer. If you have incurred a claim for nonemergency health care services from me, as an out-of-network provider, I will provide you with additional disclosures as required by Colorado law. (4 CCR 737-1.26(B)(1))

3. Contact Information for Enforcement Agencies
If you believe you received a balance bill in violation of federal or state law, you may file a complaint with:

  • Federal: U.S. Department of Health & Human Services — 1 (800) 317‑8010 or www.cms.gov/nosurprises

  • Colorado: State Board of Licensed Professional Counselor Examiners at dora_mentalhealthboard@state.co.us or at 303-894-7800.

You have the right to receive a “Good Faith Estimate” explaining how much your health care will cost.

Under the law, health care providers need to give patients who don’t have certain types of health care coverage or who are not using certain types of health care coverage an estimate of their bill for health care items and services before those items or services are provided.

  • You have the right to receive a Good Faith Estimate for the total expected cost of any health care items or services upon request or when scheduling such items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees. 

  • If you schedule a health care item or service at least 3 business days in advance, make sure your health care provider or facility gives you a Good Faith Estimate in writing within 1 business day after scheduling. If you schedule a health care item or service at least 10 business days in advance, make sure your health care provider or facility gives you a Good Faith Estimate in writing within 3 business days after scheduling. You can also ask any health care provider or facility for a Good Faith Estimate before you schedule an item or service. If you do, make sure the health care provider or facility gives you a Good Faith Estimate in writing within 3 business days after you ask.