Our Mission

Members of the Coalition Against Surprise Medical Billing, which represent accountable care providers, leading employer groups, and health insurance providers and the tens of millions of people they employ and serve each day, support meaningful solutions to end surprise medical billing that would:

- Protect patients and families from surprise medical bills sent by out-of-network providers.
- Maintain fair and equitable payments for providers with a benchmark standard based on local, competitive market-based rates.
- Help reduce consumers’ health insurance premiums and taxpayers’ costs by avoiding an arbitration process that adds unnecessary cost, delay and bureaucracy to the health system and is particularly harmful for smaller companies.

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The Problem

Millions of patients face surprise medical bills they did not expect at prices they cannot afford. While the majority of doctors and providers do their best to deliver fair, affordable care for patients and their families, there is a small but significant number of doctors and hospitals responsible for the vast majority of surprise billing.

When clinical specialists choose not to participate in health insurance providers’ networks – or if they do not meet the standards for inclusion – they often demand a blank check from patients for their services. The consequences are significant: financial stress, fighting a complicated, confusing bureaucracy, harassed by collection agencies, and often legal action for non-payment. And when a health insurance provider steps in on a patient’s behalf to cover the surprise medical bill, it raises premiums for everyone else.

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Role of Private Equity

The growing presence of private equity-backed providers is becoming an all too common influence in the health system – and one of the leading drivers behind egregious surprise medical bills that bankrupt families across the country. Out-of-network providers backed by equity firms continue to exploit a market loophole that allow them to charge exorbitant rates at patients’ expense. View the Coalition’s latest advertising on the harmful tactics from private equity firms below and why this practice needs to stop for good at https://ssbn.wpengine.com/private-equity/

The Solution

Any real solution to surprise medical bills must protect patients when they need emergency care and establish a fair, market-based benchmark based on local negotiated rates to stop abuse of the system by some providers. This benchmark would allow consumers to benefit from negotiated in-network rates and ensure fair and equitable treatment for health care providers, consumers, employers and taxpayers.

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News

ICYMI: New Analysis from Brookings Underscores How Private Equity Is Overwhelming Arbitration

Nov 19, 2024 | Arbitration, Blog Post, Private Equity

Certain private equity-backed providers are flooding the federal arbitration process with thousands of frivolous and ineligible claims, according to a new analysis from Brookings Institution researchers published in Health Affairs. The latest assessment confirms that...

Employers, Health Plans Oppose Legislation to Make Arbitration More Costly for Consumers

Nov 13, 2024 | Arbitration, Blog Post, Private Equity

While the No Surprises Act took a critical step in banning unfair, egregious surprise medical bills, certain private equity-backed providers continue to abuse and misuse the law’s arbitration process (also known as independent dispute resolution, or IDR) as a “back...

Four Provider Organizations Are Abusing and Misusing Arbitration. Employers, Patients, and Families are Paying the Price

Oct 16, 2024 | Arbitration, Blog Post, Private Equity

Prior to the passage of the No Surprises Act, certain private equity-backed health care providers designed an entire business model around strategically exiting health plans’ networks as a way to maximize out-of-network reimbursements at the expense of patients,...

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