This section of the FEDERAL REGISTER

contains regulatory documents having general

applicability and legal effect, most of which

are keyed to and codified in the Code of

Federal Regulations, which is published under

50 titles pursuant to 44 U.S.C. 1510.

The Code of Federal Regulations is sold by

the Superintendent of Documents.

Rules and Regulations Federal Register

3025 

Vol. 87, No. 13 

Thursday, January 20, 2022 

1 15 U.S.C. 1692 et seq. 

2 15 U.S.C. 1681 et seq. 

3Public Law 116–260, div. BB, tit. I, 134 Stat. 

2758 (2020). 

4See Requirements Related to Surprise Billing; 

Part I, 86 FR 36872 (July 13, 2021). The protections 

against surprise billing also apply to health benefits 

plans offered by carriers under the Federal 

Employees Health Benefits (FEHB) Act. See 5 U.S.C. 

8901(p). 

5See Requirements Related to Surprise Billing; 

Part I, 86 FR 36872 (July 13, 2021). 

6See Requirements Related to Surprise Billing; 

Part II, 86 FR 55980 (Oct. 7, 2021). 

7See, e.g., id. (interim final rule issued by Office 

of Personnel Management; Internal Revenue 

Service, Department of the Treasury; Employee 

Benefits Security Administration, Department of 

Labor; Centers for Medicare and Medicaid Services, 

Department of Health and Human Services); 

Requirements Related to Surprise Billing; Part I, 86 

FR 36872 (July 13, 2021) (same). 

8See generally Bureau of Consumer Fin. Prot., 

Consumer credit reports: A study of medical and 

non-medical collections (Dec. 2014), at 15–16, 38– 

42, https://files.consumerfinance.gov/f/201412_

cfpb_reports_consumer-credit-medical-and-nonmedical-collections.pdf. 

9See generally Debt Collection Practices 

(Regulation F), 85 FR 76734, 76735–36 (Nov. 30, 

2020). 

10 15 U.S.C. 1692a(6) (defining ‘‘debt collector’’); 

12 CFR 1006.2(i) (same). 

BUREAU OF CONSUMER FINANCIAL 

PROTECTION 

12 CFR Parts 1006 and 1022 

Bulletin 2022–01: Medical Debt 

Collection and Consumer Reporting 

Requirements in Connection With the 

No Surprises Act 

AGENCY: Bureau of Consumer Financial 

Protection. 

ACTION: Compliance bulletin and policy 

guidance. 

SUMMARY: The Bureau of Consumer 

Financial Protection (Bureau) is issuing 

this compliance bulletin and policy 

guidance (Bulletin) to remind debt 

collectors of their obligation to comply 

with the Fair Debt Collection Practices 

Act’s prohibition on false, deceptive, or 

misleading representations or means in 

connection with the collection of any 

debt and unfair or unconscionable 

means to collect or attempt to collect 

any debt, and to remind consumer 

reporting agencies and information 

furnishers to comply with the Fair 

Credit Reporting Act’s accuracy and 

dispute resolution requirements, 

including when collecting, furnishing 

information about, and reporting 

medical debts covered by the No 

Surprises Act. 

DATES: This Bulletin is applicable as of 

January 20, 2022. 

FOR FURTHER INFORMATION CONTACT: Seth 

Caffrey, Courtney Jean, Kristin 

McPartland, or Alexandra Reimelt, 

Senior Counsels, Office of Regulations, 

at 202–435–7700. If you require this 

document in an alternative electronic 

format, please contact CFPB_

Accessibility@cfpb.gov. 

SUPPLEMENTARY INFORMATION: 

I. Bulletin 

The Bureau is issuing this Bulletin to 

emphasize the obligation of debt 

collectors to comply with the Fair Debt 

Collection Practices Act’s (FDCPA) 1

prohibitions on false, deceptive, or 

misleading representations or means in 

connection with the collection of any 

debt and unfair or unconscionable 

means to collect or attempt to collect 

any debt, and the obligation of 

consumer reporting agencies and 

information furnishers to comply with 

the Fair Credit Reporting Act’s (FCRA) 2

accuracy and dispute resolution 

requirements, including when 

collecting, furnishing information about, 

and reporting medical debts covered by 

the No Surprises Act. This Bulletin 

describes certain acts or practices 

related to the collection of medical 

debts that may violate the FDCPA or the 

FCRA. The examples described in this 

bulletin are not exhaustive of all 

potential violations of the FDCPA and 

FCRA that could arise from the 

collection of such debts. 

Effective generally for plan years 

beginning on or after January 1, 2022, 

the No Surprises Act 3 protects 

participants, beneficiaries, and enrollees 

in group health plans and group and 

individual health insurance coverage 

from surprise medical bills when they 

receive, under certain circumstances, 

emergency services, non-emergency 

services from nonparticipating 

providers at participating health care 

facilities, and air ambulance services 

from nonparticipating providers of air 

ambulance services.4 In addition, the No 

Surprises Act, among other things, 

requires certain health care facilities 

and providers to disclose Federal and 

State patient protections against balance 

billing and sets forth complaint 

processes with respect to potential 

violations of the protections against 

balance billing and out-of-network cost 

sharing.5 The No Surprises Act also 

includes certain protections for 

uninsured (or self-pay) individuals from 

surprise medical bills.6 Several Federal 

agencies have published rules 

implementing the No Surprises Act.7

Several characteristics of medical debt 

pose special risks to consumers and 

distinguish it from other types of debt.8

Medical debt often results from an 

unanticipated event, such as an accident 

or sudden illness, rather than from a 

voluntary, planned transaction. 

Consumers are rarely informed of the 

costs of medical treatment in advance 

(although provisions in the No Surprises 

Act will help to remedy this), and 

because of price opacity, provider 

availability, and the emergency nature 

of some medical care, consumers may 

have only a limited ability to ‘‘shop 

around.’’ In addition, medical bills can 

be rife with errors, and the unique 

complexity of the medical billing and 

third-party reimbursement process 

exacerbates consumer confusion. A 

consumer faced with a bill for medical 

services is generally ill suited to the task 

of identifying billing errors, including, 

for example, identifying whether the 

billed services were actually received 

and whether the correct amount was 

billed. A consumer also may have 

difficulty determining whether the 

amount is covered by insurance (if 

applicable) and, if so, whether and to 

what extent the amount was already 

paid. 

If a medical bill remains unpaid after 

a certain amount of time, a medical 

provider may engage a third party to 

collect the debt.9 To the extent the third 

party qualifies as a ‘‘debt collector’’ 

under the FDCPA and its implementing 

Regulation F, the third party is subject 

to the FDCPA and Regulation F.10 The 

FDCPA and Regulation F prohibit the 

use of ‘‘any false, deceptive, or 

misleading representation or means in 

connection with the collection of any 


lotter on DSK11XQN23PROD with RULES1
3026 Federal Register / Vol. 87, No. 13 / Thursday, January 20, 2022 / Rules and Regulations 

11 15 U.S.C. 1692e; 12 CFR 1006.18(a). 

12 15 U.S.C. 1692e(2)(A); 12 CFR 1006.18(b)(2)(i). 

13 15 U.S.C. 1692f; 12 CFR 1006.22(a). 

14 15 U.S.C. 1692f(1); 12 CFR 1006.22(b). See also, 

e.g., Tuttle v. Equifax Check, 190 F.3d 9, 13 (2nd 

Cir. 1999) (noting that, if state law expressly 

prohibits service charges, a service charge cannot be 

imposed even if the contract allows it). 

15See Bureau of Consumer Fin. Prot., Market 

Snapshot: Third-Party Debt Collections Tradeline 

Reporting, at 5, 12–14 (July 2019), https://

files.consumerfinance.gov/f/documents/201907_

cfpb_third-party-debt-collections_report.pdf 

(finding that, in the second quarter of 2018, medical 

debt accounted for approximately two-thirds of 

total third-party collections tradelines). See also 

Bureau of Consumer Fin. Prot., Consumer credit 

reports: A study of medical and non-medical 

collections, at 4–5 (Dec. 2014), https://

files.consumerfinance.gov/f/201412_cfpb_reports_

consumer-credit-medical-and-non-medicalcollections.pdf (finding that, based on data from 

2012 through 2014, medical debt collections 

tradelines affected the credit reports of nearly onefifth of all consumers with credit reports); id. at 5 

(finding that, based on data from 2012 through 

2014, medical debt collection tradelines accounted 

for over half of all debt collection tradelines with 

an identifiable creditor or provider). 

16 15 U.S.C. 1681 through 1681x; 12 CFR part 

1022. 

17 15 U.S.C. 1681e(b). 

18 12 CFR 1022.42(a). 

19 15 U.S.C. 1681i, 1681s–2; 12 CFR 1022.43. 

20 5 U.S.C. 553(b). 

21 5 U.S.C. 603(a), 604(a). 

22 44 U.S.C. 3501 et seq. 

debt,’’ 11 including, for example, any 

false representation of ‘‘the character, 

amount, or legal status of any debt.’’ 12

The FDCPA and Regulation F also 

prohibit the use of ‘‘unfair or 

unconscionable means to collect or 

attempt to collect any debt,’’ 13

including, for example, the ‘‘collection 

of any amount (including any interest, 

fee, charge, or expense incidental to the 

principal obligation) unless such 

amount is expressly authorized by the 

agreement creating the debt or permitted 

by law.’’ 14

The Bureau reminds debt collectors 

about these FDCPA prohibitions. The 

prohibition on misrepresentations 

includes misrepresenting that a 

consumer must pay a debt stemming 

from a charge that exceeds the amount 

permitted by the No Surprises Act. 

Thus, for example, a debt collector who 

represents that a consumer owes a debt 

arising from out-of-network charges for 

emergency services may violate the 

prohibition on misrepresentations if 

those charges exceed the amount 

permitted by the No Surprises Act. 

Courts have also emphasized that 

collecting an amount that exceeds what 

is owed would violate the prohibition 

on unfair or unconscionable debt 

collection practices. 

Many debt collectors furnish 

information about unpaid medical debts 

to consumer reporting agencies 

(CRAs).15 Debt collectors who furnish 

information and the CRAs to which they 

furnish that information are subject to 

the FCRA and its implementing 

Regulation V.16 The FCRA and 

Regulation V impose obligations on 

CRAs and furnishers relating to the 

accuracy of information in consumer 

reports. Among these is the requirement 

that, when preparing a consumer report, 

CRAs ‘‘shall follow reasonable 

procedures to assure maximum possible 

accuracy of the information concerning 

the individual about whom the report 

relates,’’ 17 and the requirement that 

furnishers ‘‘establish and implement 

reasonable written policies and 

procedures regarding the accuracy and 

integrity of the information relating to 

consumers that it furnishes to a 

consumer reporting agency.’’ 18 The 

FCRA and Regulation V also require 

CRAs and furnishers to conduct 

reasonable and timely investigations of 

consumer disputes to verify the 

accuracy of furnished information.19

The Bureau reminds furnishers and 

CRAs that the accuracy and dispute 

obligations imposed by the FCRA and 

Regulation V apply with respect to debts 

stemming from charges that exceed the 

amount permitted by the No Surprises 

Act. Thus, for example, a debt collector 

who furnishes information indicating 

that a consumer owes a debt arising 

from out-of-network charges for 

emergency services (or a CRA that 

includes such information in a 

consumer report) may violate the FCRA 

and Regulation V if those charges 

exceed the amount permitted by the No 

Surprises Act or if the furnisher (or 

CRA) fails to meet its dispute 

obligations. 

The Bureau will closely review the 

practices of those engaged in the 

collection or reporting of medical debt. 

The Bureau will hold debt collectors 

accountable for failing to comply with 

the FDCPA and Regulation F, and it will 

hold CRAs and furnishers accountable 

for failing to comply with the FCRA and 

Regulation V. The Bureau will use all 

appropriate tools to assess whether 

supervisory, enforcement, or other 

action may be necessary. 

II. Regulatory Matters 

This Bulletin constitutes a general 

statement of policy exempt from the 

notice and comment rulemaking 

requirements of the Administrative 

Procedure Act.20 It summarizes existing 

legal requirements. It does not impose 

any legal requirements on external 

parties, nor does it create or confer any 

substantive rights on external parties 

that could be enforceable in any 

administrative or civil proceeding. 

Because no notice of proposed 

rulemaking is required in issuing this 

Bulletin, the Regulatory Flexibility Act 

also does not require an initial or final 

regulatory flexibility analysis.21 The 

Bureau has also determined that the 

issuance of this Bulletin does not 

impose any new or revise any existing 

recordkeeping, reporting, or disclosure 

requirements on covered entities or 

members of the public that would be 

collections of information requiring 

approval by the Office of Management 

and Budget under the Paperwork 

Reduction Act of 1995.22

Rohit Chopra, 

Director, Consumer Financial Protection 

Bureau. 

[FR Doc. 2022–01012 Filed 1–19–22; 8:45 am] 

BILLING CODE 4810–AM–P 

DEPARTMENT OF TRANSPORTATION 

Federal Aviation Administration 

14 CFR Part 25 

[Docket No. FAA–2014–1077; Special 

Conditions No. 25–609A–SC] 

Special Conditions: Dassault Aviation 

Model Falcon 6X Airplane; Design Roll 

Maneuver 

AGENCY: Federal Aviation 

Administration (FAA), DOT. 

ACTION: Final special conditions; 

amendment. 

SUMMARY: These amended special 

conditions are issued for the Dassault 

Aviation (Dassault) Model Falcon 6X 

airplane. This airplane will have a novel 

or unusual design feature when 

compared to the state of technology 

envisioned in the airworthiness 

standards for transport-category 

airplanes. This design feature is 

electronic flight controls that affect 

maneuvering. The applicable 

airworthiness regulations do not contain 

adequate or appropriate safety standards 

for this design feature. These special 

conditions contain the additional safety 

standards that the Administrator 

considers necessary to establish a level 

of safety equivalent to that established 

by the existing airworthiness standards. 

DATES: This action is effective on 

Dassault on January 20, 2022. 

FOR FURTHER INFORMATION CONTACT: 

Todd Martin, AIR–621, Materials and 

Structural Properties Section, Technical 

Innovation Policy Branch, Policy and 

Innovation Division, Federal Aviation 

Administration, 2200 S 216th Street, 


lotter on DSK11XQN23PROD with RULES1