Stop Surprise Medical Bills
Despite the success of the No Surprises Act, certain private equity-backed providers and arbitration middlemen are systematically manipulating the law’s arbitration process — known as independent dispute resolution (IDR) — to extract maximum payments from employers and patients. This ongoing misuse and abuse of the process—continued surges in arbitration filings, sky-high final payments that overwhelmingly favor providers, and growing use of third-party IDR firms—is raising alarms about the consequences for consumer premiums and health care affordability.
Our Mission
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- 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.
The Problem
Surprise medical billing—also known as “balance billing”—made it harder for patients to afford necessary medical care, often when they least expect it. Now, with patient protections in place, certain private equity-backed providers and profit-enhancing middlemen are using the arbitration process as a business model to extract profits. This aggressive, profit-driven use of the arbitration process not only inflates costs, but it also undermines the intended goals of the No Surprises Act: to make care more affordable and accessible for patients.
Role of Private Equity
The Solution
Everyone in America deserves affordable, high-quality health coverage and care. Surprise medical bills undermine that promise, threatening the health and financial stability of millions of patients each year. Together, we must ensure patients are protected from excessive costs and empowered to make informed choices.
Latest News
Sept. 28 Virtual Briefing – Lessons Learned from the States: Surprise Billing Reforms & The Impact on Consumers’ Costs
For Evidence On How Arbitration Harms Patients, Just Look to the States
The Biden Administration will soon release new rules around a federal arbitration process, also known as independent dispute resolution (IDR). Several states that have implemented IDR processes have seen how frequently they can be abused and misused by out-of-network...
Everything is Bigger in Texas – Including the Cost of Arbitration
Two years after Texas implemented a new arbitration process for resolving surprise medical bills, the number of arbitration requests have skyrocketed to more than 50,000 requests from January to June 2021, suggesting a costly trend that will leave consumers and...
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Tell Washington it’s time to protect patients from surprise and unfair medical bills.

