NSA Arbitration & State Surprise-Billing Systems

Analysis of state-regulated vs. federal ERISA bifurcation, 30-business-day open negotiation windows, and certified IDR filing procedures.

Jurisdictional Directory Across All 50 U.S. States

Select any state on the map or from the index below to review official fee schedules, administrative dispute rules, mandatory pre-service notices, and governing state agency portals. Guides feature complete statutory citations, deadline tables, and official forms.

United States Jurisdictional Directory

Select any state to inspect statutory guidelines, governing agencies, and appeal workflows.

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Select any state on the map to view statutory guidelines and dispute procedures.All 50 States
NSA Arbitration

Texas (TX)

South
Governing State Agency
Texas Department of Insurance (TDI)
Primary Statute / Code Citation
Texas Insurance Code Chapter 1467 (Out-of-Network Claim Dispute Resolution)
Statutory Summary

Texas established comprehensive surprise medical billing protections through Senate Bill 1264 (Texas Insurance Code Chapter 1467). Following the enactment of the federal No Surprises Act (NSA), Texas operates a bifurcated dispute model where state-regulated fully insured plans fall under TDI arbitration, while self-funded ERISA plans fall under the Federal IDR system.

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State Directory & Status Listing

Alphabetical index of all 50 states and statutory reference guides.

ALSouth

Alabama

Alabama does not maintain an independent state-level surprise medical billing arbitration mechanism for commercial plans, deferring all out-of-network balance billing disputes directly to the Federal No Surprises Act (45 CFR Part 149) Independent Dispute Resolution (IDR) framework.

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AKWest

Alaska

Alaska does not maintain an independent state-level surprise medical billing arbitration mechanism for commercial plans, deferring all out-of-network balance billing disputes directly to the Federal No Surprises Act (45 CFR Part 149) Independent Dispute Resolution (IDR) framework.

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AZWest

Arizona

Arizona does not maintain an independent state-level surprise medical billing arbitration mechanism for commercial plans, deferring all out-of-network balance billing disputes directly to the Federal No Surprises Act (45 CFR Part 149) Independent Dispute Resolution (IDR) framework.

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ARSouth

Arkansas

Arkansas does not maintain an independent state-level surprise medical billing arbitration mechanism for commercial plans, deferring all out-of-network balance billing disputes directly to the Federal No Surprises Act (45 CFR Part 149) Independent Dispute Resolution (IDR) framework.

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CAWest

California

California operates a bifurcated surprise balance billing framework between state law (Assembly Bill 72 / Health & Safety Code § 1371.9) and the federal No Surprises Act (45 CFR § 149.510). For state-regulated commercial health plans, non-contracted individual health professionals practicing at in-network facilities are reimbursed under AB 72 statutory benchmarks or resolved via DMHC/CDI Independent Dispute Resolution. Self-insured ERISA plans default directly to the Federal IDR portal.

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COWest

Colorado

Colorado maintains a comprehensive state surprise medical billing framework under HB 19-1174 / C.R.S. § 10-16-704. Healthcare providers and insurers operate under a bifurcated dispute model: fully insured state-regulated plans fall under the State Arbitration & Payment Benchmark administered by Colorado Division of Insurance (DORA), while self-funded ERISA plans fall under the Federal No Surprises Act IDR portal.

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CTNortheast

Connecticut

Connecticut maintains a comprehensive state surprise medical billing framework under C.G.S. § 38a-477aa. Healthcare providers and insurers operate under a bifurcated dispute model: fully insured state-regulated plans fall under the Baseball-style Arbitration & In-Network Benchmark administered by Connecticut Insurance Department (CID), while self-funded ERISA plans fall under the Federal No Surprises Act IDR portal.

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DESouth

Delaware

Delaware does not maintain an independent state-level surprise medical billing arbitration mechanism for commercial plans, deferring all out-of-network balance billing disputes directly to the Federal No Surprises Act (45 CFR Part 149) Independent Dispute Resolution (IDR) framework.

Statutory GuideView →
FLSouth

Florida

Florida maintains a comprehensive state surprise medical billing framework under F.S. § 627.64194. Healthcare providers and insurers operate under a bifurcated dispute model: fully insured state-regulated plans fall under the State Dispute Resolution Program & Fair Market Value Settlement administered by Florida Office of Insurance Regulation (FLOIR), while self-funded ERISA plans fall under the Federal No Surprises Act IDR portal.

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GASouth

Georgia

Georgia maintains a comprehensive state surprise medical billing framework under Surprise Billing Consumer Protection Act (O.C.G.A. § 33-20E-1). Healthcare providers and insurers operate under a bifurcated dispute model: fully insured state-regulated plans fall under the Mandatory State IDR with Certified Arbitrators administered by Georgia Office of Commissioner of Insurance and Safety Fire, while self-funded ERISA plans fall under the Federal No Surprises Act IDR portal.

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HIWest

Hawaii

Hawaii does not maintain an independent state-level surprise medical billing arbitration mechanism for commercial plans, deferring all out-of-network balance billing disputes directly to the Federal No Surprises Act (45 CFR Part 149) Independent Dispute Resolution (IDR) framework.

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IDWest

Idaho

Comprehensive statutory and dispute-resolution guide for Idaho is currently undergoing verified regulatory analysis. Contact Millennova Legal for expedited jurisdiction intake support.

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ILMidwest

Illinois

Comprehensive statutory and dispute-resolution guide for Illinois is currently undergoing verified regulatory analysis. Contact Millennova Legal for expedited jurisdiction intake support.

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INMidwest

Indiana

Comprehensive statutory and dispute-resolution guide for Indiana is currently undergoing verified regulatory analysis. Contact Millennova Legal for expedited jurisdiction intake support.

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IAMidwest

Iowa

Comprehensive statutory and dispute-resolution guide for Iowa is currently undergoing verified regulatory analysis. Contact Millennova Legal for expedited jurisdiction intake support.

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KSMidwest

Kansas

Comprehensive statutory and dispute-resolution guide for Kansas is currently undergoing verified regulatory analysis. Contact Millennova Legal for expedited jurisdiction intake support.

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KYSouth

Kentucky

Comprehensive statutory and dispute-resolution guide for Kentucky is currently undergoing verified regulatory analysis. Contact Millennova Legal for expedited jurisdiction intake support.

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LASouth

Louisiana

Comprehensive statutory and dispute-resolution guide for Louisiana is currently undergoing verified regulatory analysis. Contact Millennova Legal for expedited jurisdiction intake support.

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MENortheast

Maine

Comprehensive statutory and dispute-resolution guide for Maine is currently undergoing verified regulatory analysis. Contact Millennova Legal for expedited jurisdiction intake support.

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MDSouth

Maryland

Comprehensive statutory and dispute-resolution guide for Maryland is currently undergoing verified regulatory analysis. Contact Millennova Legal for expedited jurisdiction intake support.

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MANortheast

Massachusetts

Comprehensive statutory and dispute-resolution guide for Massachusetts is currently undergoing verified regulatory analysis. Contact Millennova Legal for expedited jurisdiction intake support.

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MIMidwest

Michigan

Comprehensive statutory and dispute-resolution guide for Michigan is currently undergoing verified regulatory analysis. Contact Millennova Legal for expedited jurisdiction intake support.

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MNMidwest

Minnesota

Comprehensive statutory and dispute-resolution guide for Minnesota is currently undergoing verified regulatory analysis. Contact Millennova Legal for expedited jurisdiction intake support.

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MSSouth

Mississippi

Comprehensive statutory and dispute-resolution guide for Mississippi is currently undergoing verified regulatory analysis. Contact Millennova Legal for expedited jurisdiction intake support.

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MOMidwest

Missouri

Comprehensive statutory and dispute-resolution guide for Missouri is currently undergoing verified regulatory analysis. Contact Millennova Legal for expedited jurisdiction intake support.

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MTWest

Montana

Comprehensive statutory and dispute-resolution guide for Montana is currently undergoing verified regulatory analysis. Contact Millennova Legal for expedited jurisdiction intake support.

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NEMidwest

Nebraska

Comprehensive statutory and dispute-resolution guide for Nebraska is currently undergoing verified regulatory analysis. Contact Millennova Legal for expedited jurisdiction intake support.

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NVWest

Nevada

Comprehensive statutory and dispute-resolution guide for Nevada is currently undergoing verified regulatory analysis. Contact Millennova Legal for expedited jurisdiction intake support.

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NHNortheast

New Hampshire

Comprehensive statutory and dispute-resolution guide for New Hampshire is currently undergoing verified regulatory analysis. Contact Millennova Legal for expedited jurisdiction intake support.

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NJNortheast

New Jersey

Comprehensive statutory and dispute-resolution guide for New Jersey is currently undergoing verified regulatory analysis. Contact Millennova Legal for expedited jurisdiction intake support.

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NMWest

New Mexico

Comprehensive statutory and dispute-resolution guide for New Mexico is currently undergoing verified regulatory analysis. Contact Millennova Legal for expedited jurisdiction intake support.

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NYNortheast

New York

New York was a pioneer in balance billing reform under the 2015 Emergency Medical Services and Surprise Bills Law (Financial Services Law Article 6). The statutory dispute framework is bifurcated: state-regulated comprehensive health insurance policies are governed by New York's Independent Dispute Resolution (IDR) process through the Department of Financial Services (DFS), while self-insured employer health plans are resolved through the Federal NSA IDR portal.

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NCSouth

North Carolina

Comprehensive statutory and dispute-resolution guide for North Carolina is currently undergoing verified regulatory analysis. Contact Millennova Legal for expedited jurisdiction intake support.

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NDMidwest

North Dakota

Comprehensive statutory and dispute-resolution guide for North Dakota is currently undergoing verified regulatory analysis. Contact Millennova Legal for expedited jurisdiction intake support.

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OHMidwest

Ohio

Comprehensive statutory and dispute-resolution guide for Ohio is currently undergoing verified regulatory analysis. Contact Millennova Legal for expedited jurisdiction intake support.

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OKSouth

Oklahoma

Comprehensive statutory and dispute-resolution guide for Oklahoma is currently undergoing verified regulatory analysis. Contact Millennova Legal for expedited jurisdiction intake support.

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ORWest

Oregon

Comprehensive statutory and dispute-resolution guide for Oregon is currently undergoing verified regulatory analysis. Contact Millennova Legal for expedited jurisdiction intake support.

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PANortheast

Pennsylvania

Comprehensive statutory and dispute-resolution guide for Pennsylvania is currently undergoing verified regulatory analysis. Contact Millennova Legal for expedited jurisdiction intake support.

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RINortheast

Rhode Island

Comprehensive statutory and dispute-resolution guide for Rhode Island is currently undergoing verified regulatory analysis. Contact Millennova Legal for expedited jurisdiction intake support.

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SCSouth

South Carolina

Comprehensive statutory and dispute-resolution guide for South Carolina is currently undergoing verified regulatory analysis. Contact Millennova Legal for expedited jurisdiction intake support.

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SDMidwest

South Dakota

Comprehensive statutory and dispute-resolution guide for South Dakota is currently undergoing verified regulatory analysis. Contact Millennova Legal for expedited jurisdiction intake support.

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TNSouth

Tennessee

Comprehensive statutory and dispute-resolution guide for Tennessee is currently undergoing verified regulatory analysis. Contact Millennova Legal for expedited jurisdiction intake support.

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TXSouth

Texas

Texas established comprehensive surprise medical billing protections through Senate Bill 1264 (Texas Insurance Code Chapter 1467). Following the enactment of the federal No Surprises Act (NSA), Texas operates a bifurcated dispute model where state-regulated fully insured plans fall under TDI arbitration, while self-funded ERISA plans fall under the Federal IDR system.

Statutory GuideView →
UTWest

Utah

Comprehensive statutory and dispute-resolution guide for Utah is currently undergoing verified regulatory analysis. Contact Millennova Legal for expedited jurisdiction intake support.

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VTNortheast

Vermont

Comprehensive statutory and dispute-resolution guide for Vermont is currently undergoing verified regulatory analysis. Contact Millennova Legal for expedited jurisdiction intake support.

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VASouth

Virginia

Comprehensive statutory and dispute-resolution guide for Virginia is currently undergoing verified regulatory analysis. Contact Millennova Legal for expedited jurisdiction intake support.

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WAWest

Washington

Comprehensive statutory and dispute-resolution guide for Washington is currently undergoing verified regulatory analysis. Contact Millennova Legal for expedited jurisdiction intake support.

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WVSouth

West Virginia

Comprehensive statutory and dispute-resolution guide for West Virginia is currently undergoing verified regulatory analysis. Contact Millennova Legal for expedited jurisdiction intake support.

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WIMidwest

Wisconsin

Comprehensive statutory and dispute-resolution guide for Wisconsin is currently undergoing verified regulatory analysis. Contact Millennova Legal for expedited jurisdiction intake support.

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WYWest

Wyoming

Comprehensive statutory and dispute-resolution guide for Wyoming is currently undergoing verified regulatory analysis. Contact Millennova Legal for expedited jurisdiction intake support.

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