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.
■ 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
■ 9 million in 9 months: The No Surprises Act protected Americans from 9 million surprise medical bills in the first 9 months of its implementation – averaging about 1 million surprise medical bills a month.
■ 90,000 claims filed: Despite the Centers for Medicare and Medicaid Services (CMS)4 expecting fewer than 18,000 IDR claims to be filed in 2022, over 90,000 claims were filed in just five and a half months, far exceeding CMS estimates.
■ 25,000: Nearly 25,000 of the 90,000 IDR claims filed were initiated in Texas.
■ 16,000 disputes ineligible: Certified IDR entities found nearly 16,000 of closed disputes were ineligible for the IDR process – that’s 69% – highlighting another strategy to misuse or abuse the IDR process.
■ 600% fee increase: Late last year CMS announced the administrative fee for initiating IDR will increase in 2023 from $50 to $350 per dispute, resulting in higher costs for patients.
■16: There have been 16 lawsuits filed to weaken the patient protections written into the No Surprises Act by increasing costs and wrapping IDR entities in even more red tape.
■ 73% of voters: A strong majority of voters (73%) are concerned that lawsuits from some physician and hospital organizations could delay or overturn the patient protections in the No Surprises Act – including a majority of Democrat, Republican, and independent voters with employer-provided coverage.
■ 59 organizations: Groups representing patients, consumers, unions, and employers urged the Biden Administration to stand firmly with patients and consumers in future rulemaking and implementation of the law.
COALITION PARTNERS INCLUDE: