As part of the Consolidated Appropriations Act of 2021, Congress passed the No Surprises Act (NSA), which took effect on January 1, 2022.

The NSA is a federal law designed to protect patients from unexpected medical bills. The Good Faith Estimate (GFE) requirement is a provision of the No Surprises Act that specifically applies to uninsured and self-pay patients.

You have the right to receive a Good Faith Estimate explaining how much your health care will cost. A Good Faith Estimate shows the costs of items and services that are reasonably expected for up to 12 months of your health care needs. The estimate is based on information known at the time the estimate was created and does not include any unknown or unexpected costs that may arise during treatment.

The Good Faith Estimate is not a contract between you and the provider and does not obligate or require you to obtain any of the listed services from the provider.

Under the No Surprises Act, health care providers need to give patients who do not have certain types of health insurance or who are not using certain types of health insurance 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 non-emergency 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 items or services.

• You can ask your provider, and any other provider you choose, for a Good Faith Estimate before you schedule a service.

• If you schedule a health care item or service that is over 10 days away, your health care provider or facility should give you a Good Faith Estimate in writing within 3 business days after scheduling.

• If you schedule a health care item or service that is between 3-9 days away, your health care provider or facility should give you a Good Faith Estimate in writing within 1 business day after scheduling.

• If you schedule a health care item or service that is less than 3 days away, your health care provider or facility is not required to provide you with a Good Faith Estimate, although it is still recommended.

• If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.

Throughout your treatment, the provider may recommend additional items or services as part of your treatment that are not reflected in this estimate. These would need to be scheduled separately with your consent and the understanding that any additional service costs are in addition to the Good Faith Estimate.

If your needs change during treatment, your provider should supply a new, updated Good Faith Estimate to reflect the changes to treatment, and the accompanying cost changes.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises/consumers, email FederalPPDRQuestions@cms.hhs.gov, or call 1800-985-3059.