State Medical Billing Laws & Regulations

Alabama

Statute of Limitations: 6 years

Timely Filing Limit: 365 days

Balance Billing: Allowed

Surprise Billing Protection: No

Alabama follows federal No Surprises Act provisions but has limited state-level surprise billing protections. The statute of limitations for medical debt is 6 years. Providers must comply with timely filing requirements set by individual payers.

Key Regulations

Alaska

Statute of Limitations: 3 years

Timely Filing Limit: 365 days

Balance Billing: Allowed

Surprise Billing Protection: No

Alaska has a 3-year statute of limitations on medical debt collection. The state relies primarily on federal protections under the No Surprises Act for surprise billing scenarios. Alaska's remote geography creates unique challenges for network adequacy.

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Arizona

Statute of Limitations: 6 years

Timely Filing Limit: 365 days

Balance Billing: Not Allowed

Surprise Billing Protection: Yes

Arizona enacted surprise billing protections in 2022 limiting patient liability for out-of-network emergency services and certain non-emergency services at in-network facilities. The state prohibits balance billing for emergency services.

Key Regulations

Arkansas

Statute of Limitations: 5 years

Timely Filing Limit: 365 days

Balance Billing: Allowed

Surprise Billing Protection: No

Arkansas has a 5-year statute of limitations for medical debt. The state does not have comprehensive surprise billing legislation beyond federal requirements. Individual payer contracts govern most billing practices.

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California

Statute of Limitations: 4 years

Timely Filing Limit: 365 days

Balance Billing: Not Allowed

Surprise Billing Protection: Yes

California has robust surprise billing protections under AB 72 (2017) and AB 1611. Patients cannot be balance billed for emergency services or by out-of-network providers at in-network facilities. An independent dispute resolution process settles payment disagreements between providers and payers.

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Colorado

Statute of Limitations: 6 years

Timely Filing Limit: 365 days

Balance Billing: Not Allowed

Surprise Billing Protection: Yes

Colorado enacted comprehensive surprise billing protections in 2020 (HB 19-1174). The law limits patient cost-sharing for out-of-network emergency services and establishes a binding arbitration process for payment disputes. Balance billing is prohibited for covered emergency services.

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Connecticut

Statute of Limitations: 6 years

Timely Filing Limit: 365 days

Balance Billing: Not Allowed

Surprise Billing Protection: Yes

Connecticut has strong consumer protections including surprise billing legislation that limits patient liability for out-of-network services at in-network facilities and emergency departments. The state maintains an arbitration process for provider-payer disputes.

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Delaware

Statute of Limitations: 3 years

Timely Filing Limit: 365 days

Balance Billing: Allowed

Surprise Billing Protection: No

Delaware has a short 3-year statute of limitations for medical debt. The state relies primarily on federal No Surprises Act protections. Providers should be aware of the shorter collection window for patient balances.

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Florida

Statute of Limitations: 5 years

Timely Filing Limit: 365 days

Balance Billing: Not Allowed

Surprise Billing Protection: Yes

Florida enacted surprise billing protections under HB 221 (2016) for emergency services and HMO enrollees. The law prohibits balance billing for emergency services by out-of-network providers and establishes a dispute resolution process.

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Georgia

Statute of Limitations: 6 years

Timely Filing Limit: 365 days

Balance Billing: Not Allowed

Surprise Billing Protection: Yes

Georgia enacted surprise billing legislation (SB 359) in 2020, prohibiting balance billing for emergency services and establishing an arbitration process. The law protects patients from unexpected out-of-network charges at in-network facilities.

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Hawaii

Statute of Limitations: 6 years

Timely Filing Limit: 365 days

Balance Billing: Allowed

Surprise Billing Protection: No

Hawaii has unique insurance regulations under the Prepaid Health Care Act, which requires employers to provide health insurance. The state relies primarily on federal surprise billing protections. Hawaii's isolated geography impacts network adequacy and provider availability.

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Idaho

Statute of Limitations: 5 years

Timely Filing Limit: 365 days

Balance Billing: Allowed

Surprise Billing Protection: No

Idaho has a 5-year statute of limitations for medical debt and relies primarily on federal protections for surprise billing. The state has limited specific medical billing regulations beyond general insurance laws.

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Illinois

Statute of Limitations: 5 years

Timely Filing Limit: 365 days

Balance Billing: Not Allowed

Surprise Billing Protection: Yes

Illinois has comprehensive surprise billing protections under the Illinois Insurance Code. The law prohibits balance billing for emergency services and establishes patient protections for out-of-network services at in-network facilities. An arbitration process resolves payment disputes.

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Indiana

Statute of Limitations: 6 years

Timely Filing Limit: 365 days

Balance Billing: Not Allowed

Surprise Billing Protection: Yes

Indiana enacted surprise billing protections (HEA 1004) limiting patient liability for out-of-network emergency services. The law establishes a dispute resolution process between providers and insurers and restricts balance billing practices.

Key Regulations

Iowa

Statute of Limitations: 5 years

Timely Filing Limit: 365 days

Balance Billing: Allowed

Surprise Billing Protection: No

Iowa has a 5-year statute of limitations for medical debt collection. The state relies on federal No Surprises Act protections and does not have comprehensive state-level surprise billing legislation.

Key Regulations

Kansas

Statute of Limitations: 5 years

Timely Filing Limit: 365 days

Balance Billing: Allowed

Surprise Billing Protection: No

Kansas has a 5-year statute of limitations for medical debt. The state does not have comprehensive surprise billing legislation and relies on federal protections. Individual payer contracts set most billing requirements.

Key Regulations

Kentucky

Statute of Limitations: 5 years

Timely Filing Limit: 365 days

Balance Billing: Allowed

Surprise Billing Protection: No

Kentucky has a 5-year statute of limitations for medical debt. The state does not have comprehensive surprise billing protections beyond federal law. Kentucky regulates managed care organizations through the Department of Insurance.

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Louisiana

Statute of Limitations: 3 years

Timely Filing Limit: 365 days

Balance Billing: Allowed

Surprise Billing Protection: No

Louisiana has a relatively short 3-year statute of limitations for medical debt. The state follows federal surprise billing protections. Louisiana has specific Medicaid billing requirements and operates a managed care Medicaid program.

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Maine

Statute of Limitations: 6 years

Timely Filing Limit: 365 days

Balance Billing: Not Allowed

Surprise Billing Protection: Yes

Maine has surprise billing protections that limit patient cost-sharing for out-of-network emergency services and prohibit balance billing in certain situations. The state maintains consumer protection standards for healthcare billing.

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Maryland

Statute of Limitations: 3 years

Timely Filing Limit: 365 days

Balance Billing: Not Allowed

Surprise Billing Protection: Yes

Maryland has a unique all-payer rate-setting system regulated by the Health Services Cost Review Commission (HSCRC). This system reduces surprise billing issues by standardizing hospital charges. The state also has specific balance billing protections.

Key Regulations

Massachusetts

Statute of Limitations: 6 years

Timely Filing Limit: 365 days

Balance Billing: Not Allowed

Surprise Billing Protection: Yes

Massachusetts has comprehensive surprise billing protections and mandates that out-of-network providers at in-network facilities cannot balance bill patients. The state's health reform law provides additional consumer protections and requires most residents to have health insurance.

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Michigan

Statute of Limitations: 6 years

Timely Filing Limit: 365 days

Balance Billing: Allowed

Surprise Billing Protection: No

Michigan has a 6-year statute of limitations for medical debt and relies primarily on federal No Surprises Act protections. The state has specific regulations for auto insurance medical billing due to its no-fault auto insurance system.

Key Regulations

Minnesota

Statute of Limitations: 6 years

Timely Filing Limit: 365 days

Balance Billing: Not Allowed

Surprise Billing Protection: Yes

Minnesota has surprise billing protections that restrict balance billing for emergency services and out-of-network services at in-network facilities. The state maintains strong consumer protection standards for healthcare billing practices.

Key Regulations

Mississippi

Statute of Limitations: 3 years

Timely Filing Limit: 365 days

Balance Billing: Allowed

Surprise Billing Protection: No

Mississippi has a 3-year statute of limitations for medical debt. The state does not have comprehensive surprise billing legislation and relies on federal protections. Mississippi has specific Medicaid billing requirements for its managed care program.

Key Regulations

Missouri

Statute of Limitations: 5 years

Timely Filing Limit: 365 days

Balance Billing: Not Allowed

Surprise Billing Protection: Yes

Missouri has enacted surprise billing protections (SB 579) that restrict balance billing for emergency services and certain out-of-network situations. The state maintains consumer protections through the Department of Commerce and Insurance.

Key Regulations

Montana

Statute of Limitations: 5 years

Timely Filing Limit: 365 days

Balance Billing: Allowed

Surprise Billing Protection: No

Montana has a 5-year statute of limitations for medical debt and relies on federal surprise billing protections. The state has specific requirements for rural health clinics and critical access hospitals given its rural geography.

Key Regulations

Nebraska

Statute of Limitations: 5 years

Timely Filing Limit: 365 days

Balance Billing: Allowed

Surprise Billing Protection: No

Nebraska has a 5-year statute of limitations for medical debt collection. The state relies on federal No Surprises Act protections and does not have comprehensive state-level surprise billing legislation.

Key Regulations

Nevada

Statute of Limitations: 6 years

Timely Filing Limit: 365 days

Balance Billing: Not Allowed

Surprise Billing Protection: Yes

Nevada enacted comprehensive surprise billing protections (SB 426, 2019) that prohibit balance billing for emergency services and limit out-of-pocket costs for patients receiving out-of-network care at in-network facilities.

Key Regulations

New Hampshire

Statute of Limitations: 3 years

Timely Filing Limit: 365 days

Balance Billing: Allowed

Surprise Billing Protection: No

New Hampshire has a 3-year statute of limitations for medical debt. The state follows federal surprise billing protections and has general insurance regulations through the Department of Insurance.

Key Regulations

New Jersey

Statute of Limitations: 6 years

Timely Filing Limit: 365 days

Balance Billing: Not Allowed

Surprise Billing Protection: Yes

New Jersey has strong surprise billing protections under the Out-of-Network Consumer Protection Act (2018). The law establishes an arbitration process for out-of-network billing disputes and prohibits balance billing for emergency and inadvertent out-of-network services.

Key Regulations

New Mexico

Statute of Limitations: 6 years

Timely Filing Limit: 365 days

Balance Billing: Not Allowed

Surprise Billing Protection: Yes

New Mexico has surprise billing protections that limit patient liability for out-of-network emergency services. The state maintains consumer protection standards through the Office of Superintendent of Insurance.

Key Regulations

New York

Statute of Limitations: 6 years

Timely Filing Limit: 365 days

Balance Billing: Not Allowed

Surprise Billing Protection: Yes

New York was a pioneer in surprise billing protections with its Emergency Medical Services and Surprise Bills law (2015). The law established an independent dispute resolution process and prohibits balance billing for emergency services and surprise out-of-network services. New York's law served as a model for the federal No Surprises Act.

Key Regulations

North Carolina

Statute of Limitations: 3 years

Timely Filing Limit: 365 days

Balance Billing: Allowed

Surprise Billing Protection: No

North Carolina has a 3-year statute of limitations for medical debt. The state relies on federal surprise billing protections. North Carolina has specific requirements for certificate-of-need programs affecting hospital billing.

Key Regulations

North Dakota

Statute of Limitations: 6 years

Timely Filing Limit: 365 days

Balance Billing: Allowed

Surprise Billing Protection: No

North Dakota has a 6-year statute of limitations for medical debt and relies on federal protections for surprise billing. The state has specific billing requirements for its Medicaid expansion program.

Key Regulations

Ohio

Statute of Limitations: 6 years

Timely Filing Limit: 365 days

Balance Billing: Not Allowed

Surprise Billing Protection: Yes

Ohio has enacted surprise billing protections (HB 388) that restrict balance billing for emergency services and establish patient protections for out-of-network services received at in-network facilities.

Key Regulations

Oklahoma

Statute of Limitations: 5 years

Timely Filing Limit: 365 days

Balance Billing: Allowed

Surprise Billing Protection: No

Oklahoma has a 5-year statute of limitations for medical debt. The state does not have comprehensive surprise billing legislation beyond federal requirements. Oklahoma operates a competitive healthcare market with limited price regulation.

Key Regulations

Oregon

Statute of Limitations: 6 years

Timely Filing Limit: 365 days

Balance Billing: Not Allowed

Surprise Billing Protection: Yes

Oregon has surprise billing protections (HB 2089) that prohibit balance billing for emergency services and limit patient liability for out-of-network services at in-network facilities. The state also requires price transparency.

Key Regulations

Pennsylvania

Statute of Limitations: 4 years

Timely Filing Limit: 365 days

Balance Billing: Not Allowed

Surprise Billing Protection: Yes

Pennsylvania has surprise billing protections (Act 112, 2020) that prohibit balance billing for emergency services and establish a dispute resolution process. The state also maintains comprehensive consumer protection standards.

Key Regulations

Rhode Island

Statute of Limitations: 10 years

Timely Filing Limit: 365 days

Balance Billing: Allowed

Surprise Billing Protection: No

Rhode Island has a lengthy 10-year statute of limitations for medical debt. The state relies on federal surprise billing protections and maintains insurance regulations through the Department of Business Regulation.

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South Carolina

Statute of Limitations: 3 years

Timely Filing Limit: 365 days

Balance Billing: Allowed

Surprise Billing Protection: No

South Carolina has a 3-year statute of limitations for medical debt. The state does not have comprehensive surprise billing legislation and relies on federal protections under the No Surprises Act.

Key Regulations

South Dakota

Statute of Limitations: 6 years

Timely Filing Limit: 365 days

Balance Billing: Allowed

Surprise Billing Protection: No

South Dakota has a 6-year statute of limitations for medical debt. The state relies on federal No Surprises Act protections and has general insurance regulations through the Division of Insurance.

Key Regulations

Tennessee

Statute of Limitations: 6 years

Timely Filing Limit: 365 days

Balance Billing: Allowed

Surprise Billing Protection: No

Tennessee has a 6-year statute of limitations for medical debt. The state relies on federal protections for surprise billing. Tennessee operates the TennCare Medicaid managed care program with specific billing requirements.

Key Regulations

Texas

Statute of Limitations: 4 years

Timely Filing Limit: 365 days

Balance Billing: Not Allowed

Surprise Billing Protection: Yes

Texas enacted comprehensive surprise billing protections under SB 1264 (2019), one of the strongest state laws in the country. The law prohibits balance billing for emergency services and out-of-network services at in-network facilities, and establishes a mediation/arbitration process for payment disputes.

Key Regulations

Utah

Statute of Limitations: 6 years

Timely Filing Limit: 365 days

Balance Billing: Allowed

Surprise Billing Protection: No

Utah has a 6-year statute of limitations for medical debt collection. The state relies on federal surprise billing protections and maintains general insurance regulations through the Insurance Department.

Key Regulations

Vermont

Statute of Limitations: 6 years

Timely Filing Limit: 365 days

Balance Billing: Not Allowed

Surprise Billing Protection: Yes

Vermont has surprise billing protections and maintains comprehensive healthcare regulation through the Green Mountain Care Board. The state limits balance billing and maintains strong consumer protections for healthcare billing.

Key Regulations

Virginia

Statute of Limitations: 5 years

Timely Filing Limit: 365 days

Balance Billing: Not Allowed

Surprise Billing Protection: Yes

Virginia enacted surprise billing protections (HB 1251/SB 172, 2020) that prohibit balance billing for emergency services and certain scheduled services at in-network facilities. The law establishes an arbitration process for payment disputes.

Key Regulations

Washington

Statute of Limitations: 6 years

Timely Filing Limit: 365 days

Balance Billing: Not Allowed

Surprise Billing Protection: Yes

Washington has comprehensive surprise billing protections under the Balance Billing Protection Act (2019). The law prohibits balance billing for emergency services and establishes a dispute resolution process. Washington also has strong healthcare price transparency requirements.

Key Regulations

West Virginia

Statute of Limitations: 10 years

Timely Filing Limit: 365 days

Balance Billing: Allowed

Surprise Billing Protection: No

West Virginia has a lengthy 10-year statute of limitations for medical debt. The state relies on federal surprise billing protections and maintains general insurance regulations. West Virginia has specific Medicaid billing requirements.

Key Regulations

Wisconsin

Statute of Limitations: 6 years

Timely Filing Limit: 365 days

Balance Billing: Not Allowed

Surprise Billing Protection: Yes

Wisconsin has surprise billing protections that limit patient liability for out-of-network emergency services. The state maintains balance billing restrictions and consumer protection standards through the Office of the Commissioner of Insurance.

Key Regulations

Wyoming

Statute of Limitations: 8 years

Timely Filing Limit: 365 days

Balance Billing: Allowed

Surprise Billing Protection: No

Wyoming has an 8-year statute of limitations for medical debt. The state relies on federal surprise billing protections and has general insurance regulations. Wyoming's rural geography impacts provider network availability.

Key Regulations