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What should I know about debt collection and credit reporting if my medical bill was sent to collections?

Debt collection or credit reporting on medical bills that exceed amounts permitted by the No Surprises Act may violate federal laws.

When a medical bill is unpaid, a provider may use a third-party debt collector to try to collect the bill. A collection agency, as well as a lawyer or law firm collecting a debt, may be a debt collector under a federal law, the Fair Debt Collection Practices Act (FDCPA). Another federal law, the Fair Credit Reporting Act (FCRA), may also provide protections to you. On January 13, 2022, the CFPB issued a bulletin reminding debt collectors and consumer reporting agencies of their obligations under these laws specific to the No Surprises Act (NSA). The NSA became effective on January 1, 2022 and protects you from surprise medical bills.

Debt Collection. The FDCPA prohibits the use of false, deceptive, or misleading representations in the collection of any debt. This includes the false representation of the character, amount, or legal status of any debt. That prohibition means a debt collector cannot misrepresent that you must pay a debt arising from a charge that exceeds the amount permitted by the No Surprises Act (NSA). The NSA applies to many types of surprise medical bills and became effective on January 1, 2022. For example, if you have insurance, a debt collector who claims you owe a debt arising from charges at out-of-network rates for emergency services could violate the FDCPA if those charges exceed the amount permitted by the NSA. Courts also have ruled that collecting an amount that exceeds what is owed would violate the FDCPA prohibition on unfair or unconscionable debt collection practices.

If you believe that a debt collector is trying to collect a debt that exceeds the amount permitted by the NSA, you should dispute the debt in writing by sending a letter to the collector as soon as possible. This protects your rights under the FDCPA and puts the collector on notice that it may be trying to collect an impermissible amount.

Credit Reporting. Debt collectors may also provide or “furnish” information about unpaid medical debts to consumer reporting companies, also known as credit bureaus or consumer reporting agencies (CRAs). Debt collectors who furnish information and the CRAs to which they furnish that information are subject to the FCRA and its rules. These laws put requirements on CRAs and furnishers on the accuracy of the information in your consumer or credit reports. One requirement is that, when preparing a credit report, CRAs “shall follow reasonable procedures to assure maximum possible accuracy of the information concerning the individual about whom the report relates.” For example, if a debt collector who furnishes information indicating that you owe a debt arising from out-of-network charges for emergency services (or a CRA that includes such information in a credit report) may violate the FCRA and its rules if those charges exceed the amount permitted by the No Surprises Act. Additionally, violations of the FCRA may occur if the furnisher (or CRA) fails to meet its obligations if you dispute the information.

If you need additional help or resources with your medical debt issues, you can:

  • If a debt collector contacts you about a surprise medical bill, or if you see surprise medical charges listed as negative items on your credit report, you can submit a complaint with the CFPB online or by calling (855) 411-CFPB (2372).
  • Contact the Centers for Medicare & Medicaid Services No Surprises Help Desk at 1-800-985-3059 from 8 am to 8 pm EST, 7 days a week, to submit your question or a complaint. You can also check their No Surprises Act website .
  • Speak with a lawyer. You may also qualify for free legal services in your community, if you need additional help and legal advice.
  • If you are a servicemember, you can contact your legal assistance office .
  • Submit a complaint to your state attorney general . Your state may have additional protections for consumers with medical debt in addition to federal law.