A new letter from leading employers, unions and health plans stresses the importance of The No Surprises Act in safeguarding patients from roughly more than 25 million surprise medical bills since 2022.

Members of the Coalition Against Surprise Medical Billing (CASMB) called on congressional leaders to reinforce the law’s core consumer protections that are designed to deliver cost-savings for millions of Americans. The group’s latest letter highlights new data which shows that the No Surprises Act has led to an increase in doctors and specialists participating in health plans’ provider networks, a critical policy goal designed to increase access to affordable, in-network care.

At the same time, the data also show that certain out-of-network providers continue to overutilize the federal independent dispute resolution (IDR) process at a rate 14 times greater than initial estimates. This trend underscores the need for Congress and the Administration to ensure that the arbitration process is not exploited, but rather, provides a predictable, consistent and uniform process as a last resort for dispute resolution.

Highlights from the letter are included below:

  • “Extrapolating the latest data from AHIP and the Blue Cross Blue Shield Association, the law has prevented more than 25 million surprise medical bills from health care facilities, providers, and air ambulances from reaching patients since implementation in January 2022. Further, data shows health plan provider networks have grown – a testament to the law’s impact in achieving one of Congress’ priorities of expanding access to affordable, in-network care.”
  • “During the first nine months of 2023, more than 10 million unique claims from health care facilities, providers, and air ambulance providers were subject to the protections under the No Surprises Act. Health care providers have widely accepted the initial payment made by health insurance plans (80% of the time), reflecting confidence in payments based on fair market rates and the law’s Qualifying Payment Amount (QPA). 96% of out-of-network claims are resolved outside of the independent dispute resolution (IDR) process.”
  • “Health plans are expanding networks since the law was passed. 67% of health insurance plans indicated that they increased their provider networks since the enactment of the No Surprises Act. No health insurance plans reported decreases in provider networks, indicating that the law is succeeding in protecting networks.”
  • “Unfortunately, and as predicted, the data also show certain private equity-backed providers and out-of-network doctors are likely exploiting the IDR process. Before the No Surprises Act took effect, federal agencies estimated that 17,000 claims would go through the IDR process annually. However, between April 15, 2022, and March 31, 2023, alone, 334,828 disputes were initiated through IDR, nearly fourteen times greater than initial projections.”
  • “Further, providers have also mounted an aggressive legal campaign seeking to undermine the No Surprise Act’s vital reforms. Given these ongoing threats to the law’s safeguards, it is essential that Congress and the administration continue to promote a predictable, consistent, and uniform IDR process and that ongoing implementation of the law adheres to Congressional intent in lowering costs for consumers, employers, and taxpayers.”
  • “The No Surprises Act is achieving two of its most important goals – protecting millions of consumers, while preserving in-network care. As the Departments move forward with full implementation improving the IDR process for all stakeholders, including refining the IDR process to discourage overutilization, our coalition members are hopeful that cost savings can be achieved. While much of the attention has been on elements of the IDR process that must work better, the law has been working well for the overwhelming majority of care that is subject to the protection of the No Surprises Act.”

To read the full letter, click here.