The Perils of Government-Mandated Arbitration
Protecting patients from surprise bills requires us to address the market failure that drives the problem in the first place. Arbitration is a failed remedy that will incentivize exorbitant charges moving forward. Learn more about why arbitration will continue to lead to sky-high charges from out-of-network providers and higher premiums for all of us.
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...
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...
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...
ICYMI: Arbitration Roulette—When Outcomes Depend on the Arbitrator, Not the Facts
A new Health Affairs article published by researchers at Georgetown University’s Center on Health Insurance Reforms and released as a companion article to an earlier analysis, highlights alarming inconsistencies in how arbitrators are resolving payment disputes under...
ICYMI: Private Equity-Backed Providers and Profit-Enhancing Middlemen Have Made Manipulating the IDR Process a Business Model
Certain health care providers—particularly large, private equity-backed groups—are increasingly dominating the federal Independent Dispute Resolution (IDR) process established under the No Surprises Act, according to new data from the Centers for Medicare &...