ICYMI: Bloomberg Showcases How Certain Providers Continue to Overuse Arbitration

Dec 6, 2022 | Blog Post

Despite the No Surprises Act preventing 9 million surprise bills in the first 9 months of 2022, private equity-backed groups and certain providers continue their attempts to weaken the patient protections and drive up costs and red tape through a series of lawsuits.

Bloomberg highlighted that as these lawsuits continue, including a third lawsuit just filed by the Texas Medical Association, health care systems across the country are being harmed. As certain providers and private equity-backed groups prioritize higher and higher payments in the arbitration process, they have overloaded the IDR system with an influx of claims. Now, the system has a growing backlog of unresolved claims.

It’s clear that the No Surprises Act is essential legislation for lowering health care costs and protecting patients. Even recent polling shows voters are highly concerned about efforts to weaken the law. As implementation continues, it is essential the No Surprises Act regulations remain in place to continue serving patients and end the financial harm of surprise bills, just as Congress intended when they wrote the law.

Read the full article here and see below for key quotes.

  • “Litigation over the Biden administration’s process for resolving surprise medical billing disputes threatens to exacerbate a growing backlog in claims.”
  • “If the court strikes down the rule, insurers and providers would likely continue to see “long delays in claim resolution and additional costs” associated with the IDR process, said Jeremy Hays, who represents employers in disputes as of counsel at Ogletree Deakins.”
  • “Congress passed the No Surprises Act in 2020 to protect Americans who “unknowingly got medical care from a provider or facility outside their health plan’s network,” which often happens in emergencies, said Ellen Montz, deputy administrator and director of the Center for Consumer Information and Insurance Oversight at the CMS.”
  • “The HHS received over 90,000 claims in the first five and a half months after it launched the IDR portal in April, “which is substantially more than the department initially estimated would be submitted for a full year,” a spokesperson for the CMS said.”

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