Congress tightens surprise medical bill penalties to protect patients
H.R. 4710 — No Surprises Act Enforcement Act · Filed by Gregory Murphy (R-NC) · 38 cosponsors · Introduced Jul 23, 2025 · Referred to committee
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What it does
This bill strengthens enforcement of the No Surprises Act—a 2022 law that protects patients from unexpected out-of-network medical bills. It increases penalties on health plans and insurers that violate balance-billing rules from $100/day to $10,000 per violation, adds a 3x penalty for late or non-payment of independent dispute resolution (IDR) determinations, and requires regular public reporting to Congress on audits, complaints, and enforcement actions.
Why we flagged it
The bill's core function is to strengthen existing consumer protections against surprise medical bills by raising penalties and adding enforcement mechanisms. It is not a new right or program, but a tightening of existing law through higher financial consequences and transparency reporting.
What the text implies
- The 3x penalty on late/non-payment of IDR determinations may incentivize health plans to settle disputes faster, potentially reducing litigation and administrative costs for providers—an indirect benefit to healthcare providers beyond the patient protection mechanism.
- Mandatory semi-annual reporting to Congress creates a public record of the most common balance-billing violations, which may enable targeted legislative or regulatory follow-up if certain patterns emerge.
- The bill does not cap the total penalties a single plan or issuer can face, meaning large national insurers could face substantial aggregate liability if violations are widespread, creating pressure to invest in compliance infrastructure.
- Air ambulance services are explicitly covered, suggesting Congress views this sector as a particular source of surprise bills—the bill may disproportionately affect air ambulance operators' revenue if they have been relying on out-of-network billing.
Section numbers refer to the bill text the analysis read — linked under Primary records below.
Who it affects
Ordinary patients gain stronger protection against surprise medical bills through higher financial penalties that incentivize compliance, faster payment enforcement with interest, and public transparency on how often violations occur and which providers/plans are violating the law. Health plans and insurers bear the cost of compliance, but that cost is passed to them, not to patients.
Who stands to gain
- healthcare providers (emergency and non-emergency)
- air ambulance operators
- independent dispute resolution entities
Named in the bill
Health plans, Health insurance issuers, Nonparticipating providers and facilities, Independent dispute resolution (IDR) entities, Secretary of Health and Human Services, Secretary of Labor, Secretary of Treasury, House Committee on Ways and Means, House Committee on Energy and Commerce, House Committee on Education and Workforce, Senate Committee on Finance, Senate Committee on Health, Education, Labor and Pensions — and 3 more
Where it stands
38 cosponsors: 21 Republicans, 17 Democrats.
- Jul 23, 2025 — Introduced · Congress.gov: “Introduced in House”
- Jul 23, 2025 — Referred to House Committee on Ways and Means and House Committee on Education and Workforce · Congress.gov: “Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and…”
Dates and quoted wording are Congress.gov's action record; the timeline shows status changes, not every procedural step.
Money around this bill
38 lobbying clients named this bill on 47 disclosure filings across 3 quarters, Dec 2025 to Jun 2026. Those filings disclosed $22,983,265 in lobbying spend. A filing names 14 bills on average, so that figure is what each filing reported, not a share belonging to this bill.
More lobbying clients named this bill than 99% of bills with at least one filing.
Gregory Murphy, the sponsor, reported $1,068,698 in PAC receipts in the 2026 cycle. $2,500 of that came from 1 PAC tied to these lobbying clients.
- American Medical Association — $5,643,000 on 2 filings
- Lockheed Martin Corporation — $4,180,000 on 1 filing
- Elevance Health, Inc. — $4,010,000 on 2 filings
- Cambia Health Solutions — $1,330,000 on 2 filings
- Blue Cross and Blue Shield Association — $990,000 on 1 filing
Lobbying Disclosure Act filings through Jul 20, 2026. A filing shows who paid to lobby on a bill it names, not what changed.
How this was measured
Analysis — Quorum's AI read the bill text published by Congress.gov (19,368 characters) on Aug 21, 2026. Section numbers in the findings refer to that text, linked below; transparency and hidden-provision scores are compared against the median of 16,222 analysed bills.
Status and sponsors — Congress.gov's bill record — actions, committee referrals and cosponsors — loaded nightly. The timeline shows status changes, not every procedural action.
Money — Senate Lobbying Disclosure Act filings whose specific-issue field names this bill for quarters ending Dec 2025 to Jun 2026. A filing's amount is reported whole beside the median number of bills a filing names; it is never divided across them. PAC receipts are FEC-reported contributions to the sponsor's candidate committee in the 2026 cycle.
As of — lobbying records through Jul 20, 2026 · page rendered 2026-10-20.
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