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HaloMD and IDR Middlemen Exploiting the No Surprises Act
The No Surprises Act was meant to protect patients from unexpected out-of-network medical bills. Instead, a new industry of profit-driven intermediaries is exploiting loopholes in the law—inflating the volume of disputes submitted for arbitration and demanding...
ICYMI: New Survey Shows IDR Loopholes Are Fueling Wasteful Spending on Ineligible Surprise Billing Claims
New AHIP/BCBSA survey adds to growing evidence of private equity’s rampant misuse of the No Surprises Act arbitration process at the expense of employers, consumers WASHINGTON — Certain private equity-backed providers and arbitration middlemen’s rampant abuse and...
CollectionPro: The Latest IDR Middleman Exploiting the No Surprises Act
The rise of the “IDR middlemen” is one of the clearest examples of how the arbitration process under the No Surprises Act is wrapping the health care system in red tape and increasing costs for patients and employers. A recent BusinessMole article highlights how...
Growing Pains & Gridlock: Why the No Surprises Act Arbitration Process Needs Course Correction
The No Surprises Act represented a landmark achievement—one designed to protect patients from unexpected medical bills. But while the law’s intent was clear, its implementation—particularly the arbitration process, also known as the independent dispute resolution...
$5 Billion and Counting: How the No Surprises Act’s Arbitration Process is Driving Up Health Care Costs
A new Health Affairs article from Georgetown University’s Center on Health Insurance Reforms reveals how the Independent Dispute Resolution (IDR) process under the No Surprises Act has veered sharply off course, driving $5 billion in wasteful health care spending that...
The Hidden Middlemen Driving Up Health Care Costs: How Revenue Cycle Managers Are Undermining the No Surprises Act
The No Surprises Act protects patients from unexpected out-of-network (OON) medical bills, but a growing industry of profit-seeking middlemen is exploiting loopholes in the system—driving up costs and threatening patient access to care, according to new research...
Guidehouse as an IDR Entity Would Be Akin to Letting the ‘Fox Guard the Hen House’
The Coalition Against Surprise Medical Billing (CASMB)—representing leading employer groups, unions and health insurance providers—sent a letter to the Trump administration strongly opposing Guidehouse, Inc.’s petition to become a Certified Independent Dispute...
Flawed & Costly Arbitration Process Adding $1 Billion in Additional Costs
While the No Surprises Act was intended to curb the worst of unfair billing practices from out-of-network providers and certain private equity firms, a recent analysis from the Niskanen Center highlights how misuse of the arbitration process is contributing to $1...
Private Equity Wins, Patients Lose in New Senate Surprise Billing Legislation
WASHINGTON — After years of certain private equity-backed providers scamming patients with costly surprise medical bills, new legislation S.2420 introduced in the Senate would add even greater costs for employers, health plans and patients. CASMB members and allies,...
Nutex Health Saw Financial Upside “Exploiting” the Arbitration Process & Exposed A New Surprise Billing Business Model
While the No Surprises Act successfully protects patients from unexpected medical bills, Nutex Health’s approach reveals how the law’s arbitration process, also known as the Independent Dispute Resolution (IDR), can be exploited for financial gain. The implications...