Consumer Protections
Medical Billing Protections in Massachusetts
In addition to federal protections like the No Surprises Act, Massachusetts has its own consumer protection laws that may apply to your medical billing dispute. Here is an overview of the protections available to you.
Key Facts: Massachusetts Medical Billing Protections
Dispute Window
180 days from Explanation of Benefits (EOB)
Applicable Statute
Consumer Protections
Massachusetts has strong consumer protections including surprise billing restrictions and external review
Surprise Billing Protection
Yes — state-level surprise billing law
Balance Billing Restrictions
Yes — state restrictions on balance billing
Key Consumer Protections in Massachusetts
- Massachusetts prohibits balance billing for emergency services by out-of-network providers.
- Patients can request an external review of denied insurance claims through the Office of Patient Protection.
- The federal No Surprises Act provides additional protections.
- Patients have the right to request an itemized bill from any healthcare provider.
- Massachusetts requires health plans to cover emergency services at in-network rates.
- Consumers can file complaints with the Massachusetts Division of Insurance.
Read the full statute: Mass. Gen. Laws ch. 176O, § 10
Disclaimer: This information is for general informational purposes only and does not constitute legal or professional advice. Laws and regulations may change. Consult a licensed attorney or certified medical billing advocate for advice specific to your situation.