About Us
The Coalition Against Surprise Medical Billing represents leading employer groups, unions, health insurance providers, and the tens of millions of people they employ and serve each day. Together, we support comprehensive protections for Americans against surprise medical bills, including:
- Ensuring that as implementation continues, the No Surprises Act regulations remain in place to serve patients and end the practice of out-of-network providers sending surprise medical bills – while also lowering costs.
- Maintaining fair and market-based payments for out-of-network care; and
- Reducing Americans’ health insurance premiums and taxpayers’ costs by avoiding an arbitration process that adds unnecessary cost, delay, and red tape to the health system.
By the Numbers: Surprise Medical Billing
- 3.3 million: Since the IDR portal launched in April 2022, more than 3.3 million disputes have been initiated, far exceeding projections from the Department of Health and Human Services.
- 87%: Providers continue to win far more often—at 87% compared to just 18% for health plans in Q4 of 2024.
- 447%: Providers are not only winning disputes more often, but when they do, their payment offers are significantly higher—a median of 447% compared to just 105% for health plans.
- 63%: In the first half of 2024, nearly two-thirds (63%) of resolved cases came from just five organizations: Team Health, SCP Health, Radiology Partners, AGS Health, and HaloMD.
- 600% fee increase: CMS increased the administrative fee for initiating arbitration in 2023 from $50 to $350 per dispute, resulting in higher costs for patients and signaling abuse or overuse of arbitration.
- $162 million: In 2023 alone, the Centers for Medicare & Medicaid Services (CMS) collected over $68 million in IDR administrative fees and over $94 million in IDRE compensation.
- 31: The 31 lawsuits filed against the No Surprises Act, implementing regulations and decisions by Independent Dispute Resolution entities are likely to increase costs and wrap the system even more with red tape.
Our Members

AHIP

American Benefits Council

The Alliance

BCBSA

The Council of Insurance Agents & Brokers

DFWBGH

EACH

EAM

ERIC

Florida Alliance for Healthcare Value

Greater Philadelphia Business Coalition on Health

HCBH

HR Policy Association

Kansas Business Group

MBGH

NAHU

National Alliance of Healthcare Purchaser Coalitions

National Business Group on Health

Nevada Business Group on Health

NCBGH

NFIB

NRA

NRF

PBGH

Pittsburgh Business Group on Health

Public Sector Healthcare Roundtable

RBGH

Society for Patient Orthopedics

St. Louis Area Business Health Coalition

TBGH

Unite Here!

Wyoming Business Coalition on Health

Latest News
$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...