Stop Surprise Medical Bills
Millions of Americans receive a surprise medical bill every year, bankrupting families and raising health care costs for everyone, including employers and taxpayers.
Our Mission
Members of the Coalition Against Surprise Medical Billing, which represent accountable care providers, leading employer groups, unions and health insurance providers and the tens of millions of people they employ and serve each day, support meaningful solutions to end surprise medical billing that would:
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- Protect patients and families from surprise medical bills sent by out-of-network providers.
- Maintain fair, market-based payments for out-of-network care.
- Help reduce health care costs for consumers and taxpayers by avoiding an arbitration process that adds unnecessary expense, delay and bureaucracy to the health system.
The Problem
Millions of patients face surprise medical bills they did not expect at prices they cannot afford. While the majority of doctors and providers do their best to deliver fair, affordable care for patients and their families, there is a small but significant number of doctors and hospitals responsible for the vast majority of surprise billing.
When clinical specialists choose not to participate in health insurance providers’ networks – or if they do not meet the standards for inclusion – they often demand a blank check from patients for their services. The consequences are significant: financial stress, fighting a complicated, confusing bureaucracy, harassed by collection agencies, and often legal action for non-payment. And when a health insurance provider steps in on a patient’s behalf to cover the surprise medical bill, it raises premiums for everyone else.
Role of Private Equity
The growing presence of private equity-backed providers is becoming an all too common influence in the health system — and one of the leading drivers behind egregious surprise medical bills that bankrupt families across the country. Out-of-network providers backed by equity firms continue to exploit a market loophole that allow them to charge exorbitant rates at patients’ expense. View the Coalition’s latest advertising on the harmful tactics from private equity firms below and why this practice needs to stop for good. Past evidence indicates that private equity firms have previously overused and misused the arbitration process, similar to the one included in the No Surprises Act, to increase their payments from health insurance providers — and ultimately patients. As we have seen in states like Texas, New York and New Jersey, the arbitration process adds levels of bureaucracy and costs that patients ultimately bear in their premiums.
The Solution
While Congress took a first step to protect patients from these surprise bills with passage of the No Surprises Act in 2020, it is more important than ever that implementation of the law adhere to the fundamental goals of making health care more affordable and understandable for patients and eliminating opportunities for abuse or misuse among out-of-network providers and private equity firms. Implementing the No Surprises Act must:
- Reduce health care costs by maintaining reasonable, market-based payments to out-of-network providers.
- Ensure broad protections against unfair, surprise medical bils by establishing clear definitions around the scope of services affected by the law.
- Avoid a cumbersome arbitration process that increases costs for patients, businesses and taxpayers.
News
Leading Consumer Organizations, Employer Groups and Policy Experts Applaud Consumer Protections Included in Latest Surprise Billing Regulations
Two of the primary goals of the No Surprises Act were to protect patients from surprise medical bills and to lower health care costs for all consumers. The key to achieving both of those priorities require common-sense patient protections that would curtail market...
Coalition Statement on Latest Interim Final Rules for the No Surprises Act
Following the release of new interim final rules (IFR) as part of the implementation of the No Surprises Act, the Coalition Against Surprise Medical Billing issued the following statement: “Ending surprise medical bills and lowering health care costs were the key...
Lessons Learned from the States: Surprise Billing Reforms & The Impact on Consumers’ Costs
Starting in 2022, patients across the country will no longer face the threat or fear of a surprise medical bill, but policy experts, consumer advocates, health insurance providers and employer representatives urged the Biden Administration to protect Americans from...
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Tell Washington it’s time to protect patients from surprise and unfair medical bills.