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
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Latest News
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...