District of Columbia Medical Bill Checker

District of Columbia medical bill laws

Surprise billing

We found no District of Columbia law of its own barring balance billing for emergency care or at in-network facilities, in the sources we checked. The federal No Surprises Act still applies to the plans it covers. (D.C. Code 31-2802)

Ground ambulance

We found no District of Columbia law limiting ground ambulance balance billing, in the sources we checked, and the federal law does not cover ground ambulance. (D.C. Code 5-416(d); 31-2802(a)(2))

Hospital financial assistance

A 2026 D.C. law requires covered health care facilities to offer free care at or below 200% of the poverty guidelines and reduced-cost care up to 500%. It applies from October 1, 2026. (D.C. Law 26-172 (Medical Debt Mitigation Amendment Act of 2026), Title II sec. 203(g); applicability: D.C. Law 26-189 (FY2027 Budget Support Act of 2026) sec. 7271)

• health care facilities required to have a financial assistance policy (not nursing, intermediate care or home health): free care at or below 200% of the guideline ($66,000 a year for a household of four); discounted care up to 500% ($165,000 for four).

Conditions in the law: Patients must live in the facility's defined primary service area. The policy may not discriminate based on insurance status, citizenship or immigration status, or assets. Discounts off amounts generally billed: 75% (200-300%), 60% (300-400%), 40% (400-500%). You can apply up to 240 days after the first bill, or any time while in collections, which must stop until a decision. Patients in SNAP, WIC, TANF, Medicaid or DC Healthcare Alliance, or experiencing or at risk of homelessness, must be offered screening and are deemed eligible if they apply with proof. Implementing Department of Health rules were not located.

Medical debt

• Health care providers and debt collectors may not report the amount or existence of any medical debt to a credit reporting agency. (D.C. Code 28-3814(dd)(6) (D.C. Law 26-172; applies via D.C. Law 26-189 sec. 7271))
• Interest on medical debt may not exceed 3% a year, and a debt collector may not charge any interest on debt from a facility that must offer financial assistance while the patient receives assistance and has not defaulted. (D.C. Code 28-3814(dd)(2) (D.C. Law 26-172; applies via D.C. Law 26-189 sec. 7271))
• A provider or debt collector collecting medical debt may not file a lien on your primary residence, and may not garnish your wages if your household income is under 500% of the federal poverty level. (D.C. Code 28-3814(dd)(5) (D.C. Law 26-172; applies via D.C. Law 26-189 sec. 7271))
• Collection may not start until 180 days after the first bill, with at least 90 days' notice. Collectors may not seek payment, sue or sell the debt while a health insurance appeal is pending or was pending in the previous 90 days. (D.C. Code 28-3814(dd)(1), (dd)(4) (D.C. Law 26-172; applies via D.C. Law 26-189 sec. 7271))

In an October 2025 interpretive rule, the CFPB said it reads federal credit reporting law as generally preempting state laws on credit report contents; the rule also says courts decide such questions (CFPB interpretive rule, 90 FR 48710 (Oct. 28, 2025)).

Complaints about a state-regulated plan go to the D.C. Department of Insurance, Securities and Banking (DISB), Consumer Services Division.

How the No Surprises Act limits surprise bills

The No Surprises Act covers people in job-based plans, individual plans and Marketplace plans. For emergency care, out-of-network air ambulance rides, and non-emergency care from an out-of-network clinician at an in-network hospital, hospital outpatient department, critical access hospital or ambulatory surgical center, you generally owe only your in-network cost-sharing. That payment counts toward your in-network deductible and out-of-pocket limit.

A provider can ask you to waive this protection for some scheduled care, but only with written notice at least 72 hours ahead (on the day you book, if you book less than 72 hours ahead, and at least 3 hours before care the same day). Some services can never be waived, including emergency medicine, anesthesiology, pathology, radiology, neonatology, assistant surgeons, hospitalists, intensivists and diagnostic services, and neither can care for unforeseen, urgent needs that come up during the visit.

Two gaps matter most. Ground ambulance rides are not covered by the federal law, and Medicare, Medicaid, VA, TRICARE and Indian Health Service coverage use their own billing protections instead. If a bill looks wrong, call the No Surprises Help Desk at 1-800-985-3059 or file a complaint with CMS.

Uninsured or self-pay: the good faith estimate dispute

If you have no insurance, or have private insurance and choose not to bill it, providers must give you a written good faith estimate when you schedule care at least 3 business days ahead, and whenever you ask. Short-term plans, health care sharing ministries, farm bureau plans and self-funded student plans count as uninsured for this rule. CMS says people in Medicare, Medicaid and other federal programs do not get a good faith estimate, even for a service their program does not cover. CMS is also not enforcing the rule that the main provider's estimate list other providers, so ask each provider you expect a bill from, such as the anesthesiologist or the lab, for its own estimate.

When a provider's bill comes in at least $400 above that provider's estimate, you can start the federal patient-provider dispute process within 120 days of receiving the initial bill. The fee is $25. While the dispute is open, the provider may not send the bill to collections and must pause late fees, and it should stop collection that has already started. The threshold is per provider, so compare each provider's bill with its own line on the estimate.

Hospital financial assistance (charity care)

Every nonprofit hospital must have a written financial assistance policy covering emergency and medically necessary care. It must publish the policy and an application, cap what it charges people eligible under the policy at the amounts it generally bills insured patients, wait at least 120 days after the first bill before actions like credit reporting or a lawsuit, and accept applications for at least 240 days after the first bill.

Some states go further and set income levels at which hospitals must give free or discounted care. Those levels are stated as a percentage of the federal poverty guidelines. For 2026, 100% of the guideline is $15,960 for one person and $33,000 for a household of four in the 48 contiguous states and DC (Alaska and Hawaii are higher). The hospital applies its own policy and decides each application.

Medical debt and credit reports

A federal rule that would have removed medical debt from credit reports was vacated by a federal court on July 11, 2025, so no general federal ban is in force. Federal law does keep one kind off reports: a veteran's medical debt for VA-authorized care from an outside provider, for a year after the care and once it is paid or settled (15 U.S.C. 1681c(a)(7)-(8); 1681a). The three national credit bureaus say they leave off paid medical collections and medical collections under $500, and wait 1 year before an unpaid one appears. Several states ban or limit medical debt reporting by law; the table below shows which. In an October 2025 interpretive rule the CFPB said it reads federal credit reporting law as generally preempting state laws on credit report contents, and that courts decide such questions (CFPB interpretive rule, 90 FR 48710 (Oct. 28, 2025)). In August 2026 a federal court in Texas held that federal law preempts a Texas law keeping certain out-of-network medical debt off credit reports, and barred Texas from enforcing it (Consumer Data Industry Ass'n v. State of Texas, No. 1:19-cv-876-RP (W.D. Tex. Aug. 10, 2026)).

Separately, federal debt collection law bars a collector from collecting any amount the law does not permit, which can include an amount the No Surprises Act does not allow (15 U.S.C. 1692f(1)).

For a nonprofit hospital, reporting a debt to a credit bureau counts as an extraordinary collection action, so the federal waiting period and the pause while you apply for financial assistance both apply to it.

Other states

Medical bill rules for every state and DC:

• Alabama
• Alaska
• Arizona
• Arkansas
• California
• Colorado
• Connecticut
• Delaware
• District of Columbia
• Florida
• Georgia
• Hawaii
• Idaho
• Illinois
• Indiana
• Iowa
• Kansas
• Kentucky
• Louisiana
• Maine
• Maryland
• Massachusetts
• Michigan
• Minnesota
• Mississippi
• Missouri
• Montana
• Nebraska
• Nevada
• New Hampshire
• New Jersey
• New Mexico
• New York
• North Carolina
• North Dakota
• Ohio
• Oklahoma
• Oregon
• Pennsylvania
• Rhode Island
• South Carolina
• South Dakota
• Tennessee
• Texas
• Utah
• Vermont
• Virginia
• Washington
• West Virginia
• Wisconsin
• Wyoming