Thanks to the No Surprises Act passed by Congress in 2020, Americans were protected from 9 million surprise bills in the first 9 months of 2022. Solutions like the No Surprises Act are the right way to protect patients from surprise bills, increase the number of in-network providers available, and make health care more affordable for everyone.

But some specialists continue to game the system – flooding the federal government in an attempt to bring down the whole effort with waste and red tape. In fact, STAT News recently highlighted a new report from the Departments of Health and Human Services, Labor, and Treasury on the much higher-than-expected number of submissions to independent dispute resolution (IDR) from providers:

  • “Health care providers, air ambulance providers, and companies working for them submitted about 90,000 out-of-network payment disputes between April 15 and Sept. 30, far more than the roughly 17,000 anticipated in a full year.”
  • “Of the roughly 11,000 disputes closed by Sept. 30 that had their eligibility challenged, 80% were ultimately found ineligible for the federal dispute resolution process.”
  • “The top 10 companies seeking resolution through the federal government initiated 75% of all disputes, excluding air ambulance cases. The top submitter was a private equity-owned company called SCP Health, which helps physician groups manage their billing, staffing, and other functions. SCP initiated 32% of all disputes. The company did not respond to a request for comment. Also high on the list were private equity-owned staffing companies Envision Healthcare and TeamHealth.”

It is time for certain providers to stop playing games with the No Surprises Act and instead, put patients first and protect them and their families from surprise medical bills –ultimately making health care more affordable for all.

Read the full story here.