Bifurcated

New York No Surprises Act & IDR Rules

Last verified: July 2026 · For informational purposes only, not legal advice

Quick answer: New York is a bifurcated state. Some disputes are governed by New York's own specified state law, while others default to the federal No Surprises Act IDR process depending on the plan type and service involved.

How it works

New York's specified state law applies to treatment by an out-of-network provider at an in-network hospital or ambulatory surgical center, HMO referrals to out-of-network providers, and a broad list of emergency specialties (anesthesia, pathology, radiology, and more). The federal IDR process applies mainly to air ambulance services.

Key dates

Federal No Surprises Act protections took effect January 1, 2022. State-specific protections vary — check the official source below for exact effective dates in this state.

Official source: Centers for Medicare & Medicaid Services — New York enforcement letter and specified state law documentation (cms.gov/nosurprises)

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