Grandchild Imposter Phone Scam Alert

The Consumer Assistance Program (CAP) has received scam reports from Vermonters who have reported receiving calls from scammers claiming to be grandchildren or lawyers representing loved ones in an emergency and that money is needed.

Grandchild Imposter Scam Alert: Hang up the phone! Call a family member or friend to verify. Don't send cash, gift cards, cryptocurrency, or wire transfers. Report scams to cap at ago.vermont.gov/cap/stopping-scams
Grandchild Imposter Scam Alert

When contacted by someone who asks for money, a gift card to be purchased, funds to be wired, or for any other financial transaction, take steps to verify the identity of your loved one in distress.

  1. Slow down. The scammers urge you to act urgently; don’t.
  2. Write down the phone number of the caller and hang up.
  3. Call your grandchild or any other person who can verify their whereabouts and well-being.
  4. Call another person in your life who cares about you. 
  5. Call CAP at 1-800-649-2424.  We care and can help identify scams.
SLOW DOWN: Scammers pressure you to act urgently. Don't! LOG THE CONTACT: Write down the info of the contact and disengage. ONE CALL: Make one call to a primary contact and discuss the incident. WHO CARES? Call CAP to identify and report scams at 1-800-649-2424.
Stop scams with the SLOW Method.

Even if you have not been contacted by this scam, now is a great time to connect with loved ones to create a scam action plan in preparation for the likely receipt of scam calls. Consider creating an uncommon family codeword or pin number that you agree to not publicize or share with others. Make a phone tree of reliable contacts to call if a scam like this is received. Learn more about family emergency scams on CAP’s website: ago.vermont.gov/family-imposter. Act now to prevent future loss.

Help CAP stop these scams by sharing this information with those you care about.

If you have lost money to this scam, contact the money transfer company right away! Report the scam to the Consumer Assistance Program at 1-800-649-2424.

For more information on the Attorney General’s efforts to support and protect older Vermonters, visit the webpage of the Attorney General’s Elder Protection Initiative.

Feeding Baby During the Formula Shortage

By Crystal Baldwin

There are only two kinds of food a newborn baby can eat: breastmilk and simulated breastmilk, otherwise known as baby formula. Formula has since the eighteen hundreds been a helpful nutritional supplement—establishing itself as a necessity to grow our infants, helping to overcome milk/food allergies or the obstacles that present in breastfeeding, and providing an alternative for families.  

Baby drinking formula from a bottle
Baby drinking formula.

At six weeks, my baby developed a milk protein allergy. Still too young to eat solids, my family began investing in the protein dense, nutrient rich smoothie that is formula to make sure she was fed.  

Sure, sometimes when I went to the store the preferred brand of her soy-based formula was out of stock. Determined, I sought alternatives to purchasing in-store, so that my baby could have the food she liked. I could buy in bulk from wholesale stores, or direct from the manufacturer online. I opted to have the containers of formula delivered to my doorstep. Upon each delivery arrival, I felt a pang of extreme gratitude in knowing that my baby would eat. I wish I could extend this feeling to every parent navigating the baby formula shortage. 

The Biden administration has highlighted the concern of the baby formula shortage with a plan to alleviate the struggle, which was predominately initiated by a voluntary recall at the largest U.S. formula manufacturer, Abbott Nutrition, three months ago.  

The federal government has been: 

  1. Working with other infant formula manufacturers to increase production, expediting the safe import of infant formula from abroad. 
  1. Calling on both online and store retailers to establish purchasing limits to prevent the possibility of hoarding.  
  1. Simplifying product offerings to increase the speed and scale of production, to stabilize the overall volume of formula available on the market. 
  1. The USDA is urging states to allow WIC recipients to use their WIC benefits on a wider variety of products so that if certain sizes or types of formula are out of stock, they can use their benefits on those that are in stock. 

The federal government is now: 

  1. Invoking the Defense Protection Act, diverting needed ingredients to infant formula manufacturers before sending the supplies to other consumer goods. 
  1. Launching Operation Fly Formula, utilizing Department of Defense commercial aircraft to transport overseas U.S. approved infant formula to deliver it to the store shelves faster
  1. The FDA is working with the largest U.S. formula producer to reopen Abbott’s Sturgis, Michigan facility.  

“On a personal note: I have firsthand experience with the formula shortage. Luckily, we’ve always been able to find alternative sources, but it’s been difficult (and scary at times).”

A Vermont Infant Parent

Vermont parents are resilient and savvy–they have been finding solutions to this problem for months. The parents that have been navigating this well know best, but perhaps I can help simplify some of the information that has been circulating. The following, in addition to the VT Department of Health’s help page released last week, might provide some level of clarity. 

Caregiver Formula Shortage Do’s and Don’ts 

Do 

  • Buy formula online direct from a verified retailer or manufacturer
    • The New York Times is regularly updating a list of online available baby formula stock, organized by formula type. 
    • Other ways to verify online formula sellers: Check BBB.org complaints and reviews, check the business registrations in the state of incorporation, perform an internet search of the company name and “scam” or “complaints” to find if others have reported problems. Double-check the website address before completing the order. Scammers will create mock websites, looking very similar to known sites.  
    • Abbott Nutrition has a hotline number for families that need specialty formula. For information and orders, call 1-800-881-0876
  • Talk to your pediatrician and lactation consultant (or similar Women, Infants and Children support services (WIC)) about healthy alternatives, such as breastfeeding, temporary use of an alternative formula, and introducing solids—where appropriate. 
    • Your pediatrician is your connection to infant safety. Stay connected regarding infant wellbeing. Lactation consultants are covered under most health insurance providers. They are nurses that provide dietary advice, supplement recommendations, and direct teaching and support for nursing mothers.  
  • Call Women, Infants and Children (WIC) and your pediatrician if you cannot adequately feed your baby.  

If this shortage has caused undue hardship and you cannot feed your baby, especially due to the lack of supply, please reach out for help. 

Do: Buy formula online direct from a verified retailer or manufacturer. Do: Use online parenting social groups, such as on Facebook, to get and share the latest supply updates. Do: Talk to your pediatrician and lactation consultant about healthy alternatives; such as breastmilk and introducing solids. Do: Call WIC and your pediatrician if you cannot adequately feed your baby. Don't: Buy from unverified sellers, including unknown websites, sellers in marketplace social groups, and international sellers that are not FDA approved. Don't: Pay more than the fair market price - report price gouging. Don't: Buy more than you need. Don't hoard. Don't: Use unsafe alternatives: like milk or homemade formula. Don't: dilute formula.
Baby Formula Shortage Caregiver Do’s and Don’ts

Don’t 

  • Don’t buy from unverified sellers, including unknown websites, sellers in online marketplace social groups, and international sellers that are not FDA approved. 
    • Scammers lurk at every disadvantage. Not engaging in disreputable activities and keeping scammers away will help everyone in the long run. 
  • Don’t pay more than the fair market pricereport price gouging to the Attorney General’s Office.  
    • When you pay more than the fair market price for a product, the price spikes, making products unaffordable for moderate and low-income Vermonters. Price gouging in a market emergency has repeatedly been proven as unfair and deceptive. If you notice steep increases in the price of formula in Vermont, report the store name and location, and as much identifying information about the product as you can provide, including the formula type, size, dollar amount, and the typical price, as well as a picture, if able to the Consumer Assistance Program of the Vermont Attorney General’s Office (CAP).  
  • Don’t buy more than you need. Please don’t hoard. 
    • This may prove difficult, particularly when feeding your baby is at stake. But the economics here are undeniable, if you buy more than you need now while there is a shortage, someone else will go without. It will be difficult, but please stick to the purchasing restrictions outlined by the retailers, as required by the federal government. Calendar your plan to make another formula purchase again before your supply is gone so that you don’t run out. 
  • Don’t use unsafe alternatives: like homemade baby formula, juice, cow’s milk, goat’s milk, plant-based milk, or watered down/diluted baby formula with water.  
    • Baby formula is made to simulate breastmilk with a specialized combination of vitamins and nutrients and its production is FDA monitored. While cow’s milk and other dairy alternatives are yummy for older children and adults, infant bodies can’t adequately digest food alternatives, including excess water, which provokes harm.   
Ally Do's and Don'ts. Do This: Check the stock while in a store and don't buy it. Use online social groups to keep others informed and updated on your findings. Offer to help friends by keeping them informed and buy only if you call them first and confirm they need the formula. Sign up to be a breastmilk donor at VT Donor Milk Center, or ask friends if they would like your excess supply. Don't - Not That: Don't buy formula that you do not need with the intention to donate. In doing so, you reduce available stock for caregivers. Don't offer unsolicited or unsafe advice, such as unrealistic goals for breastfeeding, or suggesting alternatives like milk. Don't show up with negativity. Caregivers and their children need positive support and valuable connection during this stressful time.
Ally Formula Shortage Do’s and Dont’s

This is indeed a stressful time. Those of us on the sidelines are eager to support caregivers and help where we can. While our first inclination may be to buy formula and donate it, this action creates a greater supply problem as it leaves less formula on the shelves for caregivers to purchase when they need it. Instead, if you notice available formula stock, call up an infant caregiver directly and ask them if they would like you to pick it up for them. Another thing you can do for your community is to crowdsource formula supply by taking note of the formula available in your local stores and sharing it with caregiver support groups online. When you notice scams or price gouging in an emergency, report it to CAP at 1-800-649-2424.  

References and Trusted Resources: 

VT Department of Health: Infant Formula Shortage – Find Help page 

White House – Biden Administration StatementsMay 22, 2022 Fact Sheet 1, May 22, 2022 Fact Sheet 2, May 18, 2022 Fact Sheet, May 12, 2022 Fact Sheet  

Women, Infants, and Children (WIC) 

Legal Authority Imposters 

You are busy in your work, helping people with critical problems when you get the call, “There is a bench warrant against you for not appearing in court.” Your first thought might be, “What does that even mean?” Your second thought: “How do I make it go away?”  

Legal Authority Scam Alert: Purports to be the police, sheriff, or other legal authority. Threatens legal action, arrest, or there's a warrant against you. Hang up on all threats and report them! Contact CAP 800-649-2424.
Legal Authority Scam Alert

The Consumer Assistance Program was recently notified about a rush of legal authority imposter scam calls reaching doctor’s offices in the Rutland area. In the scams reported, caller identification numbers were spoofed to appear as the “Rutland County Sheriff.” When doctors and staff questioned the legitimacy, they were told to “go ahead and call the sheriff directly.” When some did, the scam was confirmed. There was no bench warrant and paying these criminals on the spot would have resolved nothing anyway. 

What has been quite a surprise to these practitioners, has presented itself as one of the more common scams state-wide. In 2021, CAP recorded 277 reports of the Legal Authority Imposter Scam and nearly $200,000 in cumulative loss by six Vermonters. In this scam, a call comes in unexpectedly, claiming to be someone of legal authority: a sheriff, police officer, law office, U.S. Customs and Border Protection, for example. The caller expresses an urgent distressing problem, often threatening arrest, and eventually requests payment for the problem to go away.  

What to do?  

  • Never send callers money, especially in response to threats or claims of legal action. 
  • If you are concerned about a bench warrant, contact your legal counsel or the court directly. 
  • Hang up on all threats and report them.  

Know: 

  • If you were going to be sued, the papers would be served without notice. 
  • Harassing debt collection practice is unlawful, and collectors aren’t allowed to make claims they can’t or won’t pursue. Learn more about your rights.  
  • Learn more about the process of law to avoid scams. Most typically, if ordered to pay an amount, even by the court, there will be a clearly outlined process to follow to ensure payment goes to the right place. When a scammer claims legal action, research what it is and is not.  

What is a bench warrant? 

If you fail to show up in court when required (usually you are served notice by mail or by a Sheriff by hand delivery prior to the required court appearance), the judge may order for you to be detained or arrested. A bench warrant is more likely to be granted when a criminal defendant is on bail, or a subpoenaed witness fails to show up for trial. The bench warrant essentially orders you to go appear before the bench. (Cornell Law, nolo.com

How do I make a bench warrant go away? 

If you actually have a bench warrant against you, contact your attorney or public defender. A bench warrant calls for your appearance in court, so your appearance in court is what is necessary–and not the payment of funds like the scammers suggest.   

Stop all scams by following the SLOW Method.   

Slow Down: Scammers pressure you to act urgently. Don't! Log the Contact: Write down the info of the contact and disengage. One Call: Make one call to a primary contact and discuss the incident. Who Cares? Call CAP to identify and report scams at 1-800-649-2424.
Slow method – Slow down, take steps to verify.

Report scams to the Consumer Assistance Program (CAP) through CAP’s online scam reporting form or by calling 1-800-649-2424. Learn more about imposter scams on our imposter scam prevention video and resource page: ago.vermont.gov/imposter-scam

2021 Scams with Loss Reported to the Consumer Assistance Program 

Reports of scams to the Attorney General’s Consumer Assistance Program (CAP) totaled 5,154 in 2021, up just slightly from the previous year’s 5,021 reports. As imposter scams are of ongoing concern in Vermont, CAP recently distributed a video imposter scam prevention project, highlighting three concerning imposter scams with high dollar loss: the Romance Imposter scam, the Family Emergency/Imposter Scam, and the Business Imposter Email Scam.  We work in partnership with the Community of Vermont Elders (COVE), FAST of Vermont and local community partners to provide referrals and resources to victims of scams. In addition, CAP connects with service providers and local community organizations to provide training and scam prevention presentations.   

As highlighted in the prevention project, taking steps to verify can help individuals avoid scams. A simple verification process to follow for all scams is the SLOW Method

S – SLOW DOWN 
Scammers pressure you to act urgently. Don’t! 

L – LOG THE CONTACT 
Write down the info of the contact and disengage. 

O – ONE CALL 
Make one call to a primary contact and discuss the incident. 

W – WHO CARES? 
Call CAP to identify and report scams at 1-800-649-2424. 

CAP reminds Vermonters to never give out personal information or make payments to parties you cannot verify. Scammers will ask for payment in all forms, including wire transfer, cryptocurrency, cash, peer-to-peer payment, money order, check, credit/debit card, and gift cards. If you have sent money to a scammer, follow recovery steps now

Vermonters can help stop scams by sharing information with community members and by reporting scams to CAP to support educational outreach. To report scams, complete CAP’s online scam reporting form or call 1-800-649-2424. 

Top 10 Scam Types with Incurred Loss in Vermont by Total Loss Amount: Romance Imposter, $1,203,457: Financial Advisor/Investment Imposter, $820,233: Computer Tech Support, $695,240: Sweepstakes/Lottery/Contest/Prize, $439,685: Business Email Imposter, $388,295: Legal Authority Imposter, $197,011: Claims Order Made/Package Delivery, $129,818: Fake Website, $83,461: Buy/Sell Listing, $60,376: Phishing-Bank Representation, $51,436.
Top 10 Scam Types with Incurred Loss in Vermont by Total Loss Amount
Scam with Loss data according to reports to the Consumer Assistance Program in 2021

Computer Tech Support (Traditional) 

The scam: You receive a phone call, pop-up, or email on your computer claiming to be from Norton, Microsoft, Apple, or another well-known tech company. They will make claims such as your electronic device has a virus, your device security subscription has been automatically renewed, or stating you have been charged for services you did not receive or ask for. You may be prompted to click a link or call a number to contact. They will try to persuade you to give remote access to your device to fix the issue, and sometimes will even ask for immediate payment for their services. 

 How to spot the scam: Legitimate tech support companies do not display communications to their customers as random pop-ups on your device. Tech support will not call you to warn of security incidents; that your account has been renewed for a subscription you do not recognize; and will not send you random links, often shortened, with instructions for you to click on URLs. 

What to do: When contacted about a supposed business relationship, take steps to verify, especially if you do not remember signing up for services. Never click on links or provide remote access to your computer from an unknown email sender or pop-up message on your device’s screen. If you received a pop-up message you cannot click out of, shut down, restart, or unplug your device. If you get a call from “tech support”, hang up. Also, be careful when searching for tech support online. Some users have been scammed by calling illegitimate phone numbers listed on the internet. 

Fake Website/Online Listings 

The scam: Fake websites or phony listings on sites like Facebook Marketplace and Craigslist draw you into a purchase that’s likely too good to be true. This scam can also appear in online rental listings, and as a buyer offering well-over the selling price for an item. As a seller, the fake buyer sends a fake check or pays with a fraudulent credit card and asks you to advance funds to another fake vendor, causing you to be out the funds. 

How to spot the scam: Be skeptical of unrealistic offers. Watch out for requests for money in any form (gift cards, wire transfers, cash) when not made in person. Scammers likely will not want to talk on the phone or meet in person. Heed warnings in user reviews and other online commentary. 

What to do: Playing it safe online takes a bit of detective work to determine legitimacy of an offer. Investigate the person/profile of the seller. If their profile is new and they have no friends and photos, they are likely a scam. Research new websites you are considering doing business with by looking up online reviews and state business registrations, taking note of how long the company has been operating. Perform online searches of the business with “scam” and “complaints” to see if issues generate. Complete your transactions in cash and preferably a safe place in-person. 

Romance Imposter  

The Scam:  Scammers connect usually through social media and pose to be someone you trust and care for. After the trust has been developed, they claim they are in an emergency to convince you to send them money or will ask you for a favor. Scammers impersonate a love interest and play on your fears to have you send money urgently.  

How to spot the scam: Use reverse image searches to look up images of the person; if ther are many results, the contact may be using someone else’s image and is a scam. Video chat on your terms and at random times. If they are typically unavailable, they may be scamming someone else.  

What to do: consult with your close in person contacts and reach out to an organization in your life who cares. They may spot something you don’t. Never send money to someone you have not met in person.  

Computer Tech Support (Claims Order Made/Package Delivery) 

The scam: A variation of the traditional Computer Tech Support scam (see # 3 below). You receive an automated phone call, text message, or email claiming that you have been charged for an online order, have an outstanding balance on your account, or are sent an item you did not order. The scammer then instructs individuals to call a number provided in the scammer’s communications to get a refund or to resolve the charge. At this point, they will ask you to provide your card number to “confirm your account” or prompt you to provide them remote access to your computer. As soon as the scammer has remote access to your device, they can access every single document, file, and transaction you have saved to your device. 

How to spot the scam: Companies will not call with tech support unless you requested that they contact you. If you receive a package that you do not recall ordering, check your statement history to see if you have been charged. Packages without a return address are highly suspicious. 

What to do: Hang up the phone immediately and do not call back. If you receive an email or text regarding a package delivery or order that has been made, do not click on any links. Mark the email as “Junk” or “Spam”. Furthermore, never allow remote access to your device to unknown parties. If you are concerned about charges made to your accounts, log in to your account directly and contact your financial institution. If you receive a package that you did not order, mark it return to sender and give it back to the mail carrier. 

Sweepstakes/Lotteries/Contest/Prize 

The scam: You will be notified by phone, email, or mail that you won a prize or a quantity of money. In some cases, you will even receive a realistic-looking check – but it is fake! You are instructed to pay fees and give your financial and personal information to claim your prize. They often use a legitimate sweepstakes name, like Publishers Clearing House. 

How to spot the scam: Legitimate sweepstakes and contest businesses, like Publishers Clearing House and Mega Millions lottery, will contact you in person if you win a major prize. For prizes under $10,000, the notification is done through certified mail by overnight delivery services (FedEx, UPS). They will not contact you by phone, nor require a payment or processing fee to release your prize. 

What to do: If it sounds too good to be true, then it’s not true. You don’t need to pay fees or give your financial information in order to claim a prize. 

Family/Friend Emergency/Imposter 

The scam: Scammers pose to be someone you trust and pretend to be in an emergency to convince you to send them money or will ask you for a favor. These scammers pose as grandchildren, friends, relatives, and close contacts and seem like the real deal. Scammers impersonate people you love and play on your fears to have you send money urgently. After the initial call, you may be told a lawyer, parole officer or courtroom may contact you for further information. 

How to spot the scam: Contacts come in as calls or emails or online messages. Sometimes it’s someone you haven’t heard from in a while. They require urgency and ask for secrecy. You may not be allowed to speak to your loved one on the phone. 

What to do: Take steps to verify. Check out if they really are who they say even if they sound like a loved one. Slow down your response and contact someone you trust to verify if there is an emergency. You can also choose a “code word” with friends and family to verify the person is who they claim to be. If they don’t know the word, they are not your friend or family member. 

Phishing-Bank Representation 

The scam: You receive an email or phone call claiming to be from a bank. Emails might claim that your account is in danger or has been suspended, or that your card is on hold due to suspicious activity. The email also includes links to phony websites. Phone calls may claim that there has been fraudulent activity involving your account, and the scammers demand personal information about you and your account. 

How to spot the scam: Scammers mask their actual identity by changing the sender name to the name of the financial institution. Look at the email address before opening the email. You will often find an account not affiliated with your bank. Similarly, scammers can spoof phone numbers of financial institutions. If you answer a call that appears to be from your bank and they ask for your personal and/or account information, hang up and call your bank directly on a number you trust to verify their attempt to contact you. 

What to do: Do not reply to the email or click on any links or attachments included in the message. If you receive a call, hang up the phone. To correspond directly with your bank or financial institution, use verified contact information, such as information listed on your statement. 

Financial Advisor/ Investment Imposter  

The scam: Scammers are spoofing websites and using fake social media accounts to obscure their identities. Scammers also pose an imposter friend with an investment tip.  Investors should always take steps to identify phony accounts by looking closely at content, analyzing dates of inception and considering the quality of engagement. To ensure investors do not accidently deal with an imposter firm, pay careful attention to domain names and learn more about how to protect your online accounts. 

How to spot the scam: Beware of fake client reviews. Scammers often reference or publish positive, yet bogus testimonials purportedly drafted by satisfied customers. These testimonials create the appearance the promoter is reliable – he or she has already earned significant profits in the past, and new investors can reap the same financial benefits as prior investors. 

What to do: The North American Securities Administrators Association (NASAA) recommends investors independently research registration of investment firms.  

No More Surprise Out-of-Network Medical Bills

By Crystal Baldwin

The Consumer Assistance Program’s (CAP) top consumer complaints of 2021 ranks health/medical concerns fourth among the primary problems reported by Vermont consumers, with issues including billing and charge disputes. While the Consumer Assistance Program provides informal mediation on medical billing disputes involving providers, there are several resources available to consumers to resolve medical billing disputes, particularly if a regulated business, such as an insurance provider is involved. In the medical billing realm, consumers have earned more protections just this January through the Federal No Surprises Act, aka the “No Surprises Act” or the “No Surprise Billing Act.”

The No Surprises Act prevents surprise medical bills and has changed how unanticipated out-of-network bills can be assessed. The intention of the act is to remove the surprise that accompanies receiving large unanticipated bills after receiving health care services. There is a lot to know and there are already a number of resources to help you understand the act and your rights more thoroughly, including information on Centers for Medicare & Medicaid Services and the U.S. Department of Health & Human Services websites. 

The No Surprises Act gives some medical billing control back to the consumer.

https://www.youtube.com/watch?v=eKJscqVwYls
No More Surprise Medical Bills: 5 Things To Know about the No Surprises Act Taking Effect in 2022 – From HHS.gov

Key information you should know about this new law:

Who does it cover?

People covered under group and individual health plans.

What does the law provide?

Protection from receiving surprise medical bills for most:

  • Emergency services
  • Non-emergency services from out-of-network providers at in-network facilities
  • Services from out-of-network air ambulance service providers

It…

  • Bans surprise billing in private insurance for most emergency care and some instances of non-emergency care.
No Surprises Statement
No Surprises Statement
  • Requires that uninsured and self-pay patients receive key information, including overviews of anticipated costs and details about their rights.
  • Bans surprise bills for emergency care and requires that cost-sharing for these services–like co-pays—always be based on in-network rates, even when care is received without prior authorization.
  • Bans surprise bills from certain out-of-network providers if you go to an in-network hospital for a procedure; cost sharing for certain additional services during your visit will generally be based on in-network rates.
  • Requires providers and facilities to share with patients easy-to understand notices that explain the applicable billing protections and who patients should contact if they have concerns that a provider or facility has violated the new surprise billing protections.
  • Requires most providers to give a “good faith estimate” of costs before providing non-emergency care for people who do not have health insurance or pay for care on their own.
  • Protects against “Balance Billing” abuse. Balance billing is when a provider bills for the difference between the provider’s charge and the allowed amount.
  • Prohibits a preferred provider from balance billing.
  • Prevents air ambulance services from imposing cost-sharing greater than the in-network cost.

When might the law not apply?

While there are many protections in place, a patient may agree to balance billing for certain non-emergency situations, however this must be disclosed in writing and utilize a specific “Surprise Billing Protection Form.” By signing the form, patients agree to give up their federal consumer protections, agreeing to pay more for out-of-network care.

This notice and consent waiver for balance billing is NOT permitted for:

Code Blue sign in hospital
  • Emergency services
  • Unforeseen urgent medical needs arising when non-emergent care is furnished
  • Items/care related to emergency services
  • Diagnostic services including radiology and lab services
  • Out-of-network provider services when in-network providers cannot provide necessary such service

Surprise bills may continue to be issued by the following facilities:

Newborn and mother
  • Birthing centers
  • Clinics
  • Hospice
  • Addiction treatment facilities
  • Nursing homes
  • Urgent care centers (by circumstance)

What if you receive a surprise bill?

There is an independent dispute resolution process for payment disputes between plans and providers as well as new dispute resolution opportunities for uninsured and self-pay individuals.

For remaining questions about the law, visit: cms.gov/nosurprises

What about medical billing disputes not covered under the law?

For those bills that still are not covered, there are some important resources still available to consumers:

Dispute Resolution ResourceIssue
Centers for Medicare & Medicaid ServicesMedicare billing disputes
ERISAPrivate-sector/work place health benefit insurance plan disputes
Insurance Division of the Vermont Department of Financial RegulationHealth insurance billing dispute
Patient Financial Assistance Program of the provider, such as the program available at UVMMCChallenges paying valid medical bills
State Health Insurance Program (SHIP):Help understanding health insurance, including Medicare and Medicaid
Vermont Health Care Advocate (HCA) HelpLine:
1-800-917-7787  
Assistance obtaining free and lower-cost health coverage. Advice and support in solving medical billing problems, including Medicaid. Assistance deciphering health plan coverage.

As described in CAP’s blog a few years back, Navigating Health Care Can Be Tough, click the blog for even more helpful resources. Contact CAP for assistance resolving provider billing disputes.