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.
- $5 billion: The IDR process has generated at least $5 billion—about $2 to $2.5 billion annually—in total costs (combining required fee payments, administrative costs, and additional payments for services) through the end of 2024.
- 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
No Results Found
The page you requested could not be found. Try refining your search, or use the navigation above to locate the post.
Latest News
ICYMI: Private Equity Cashes in on Routine Births
Harmful surprise billing practices exacerbated by private equity involvement in health care were recently highlighted by Fortune and Kaiser Health News. Patient Elizabeth Huffner was expecting and past her due date, so when she went into labor and headed to the...
ICYMI: A Tale of Two States – Surprise Billing Laws in California and New York Led to Dramatically Different Costs for Patients
A recent study published in Health Affairs compared policies in New York, where out-of-network bills have increased by 24% because existing state law allows the arbitration process to rely on billed charges (billing charges increased from assistant surgeons and...
ICYMI: Kaiser Health News Highlights the Downsides of Private Equity Investments in Health Care
A recent article from Kaiser Health News highlights how investments from private equity firms can destabilize the American health care system. In one example, a small hospital system in Missouri was struggling to stay open, and the backing of Noble Health, a private...