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
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Latest News
Recent Report Details How Arbitration Could Become “Permanent Cost Escalator”
When Congress passed the No Surprises Act, the goal was clear: protect patients from unexpected out-of-network medical bills. The law has largely succeeded in that regard, shielding patients from most surprise bills — especially large balance bills tied to emergency...
Abuse & Misuse of Arbitration Fueling Affordability Crisis
The evidence of certain providers' routine abuse and misuse of the No Surprises Act’s Independent Dispute Resolution (IDR) process, also known as arbitration, has been overwhelming. Recent lawsuits reveal repeated and persistent patterns of fraudulent IDR submissions,...
Latest IDR Data Confirms Ongoing Abuse by Private Equity-Backed Providers and IDR Middlemen
The Centers for Medicare & Medicaid Services (CMS) just released new data from the first half of 2025 on the No Surprises Act’s Independent Dispute Resolution (IDR) process, and the numbers are staggering. Nearly 1.2 million disputes were filed in just six months,...