ICYMI: WSJ: Medical Billing Arbitration Paid Out $15 Billion to Providers in Surprise Bill Disputes

Jul 22, 2026 | Arbitration, Blog Post

The Wall Street Journal previewed new CMS data that show $15 billion in independent dispute resolution (IDR) awards to out-of-network providers under the No Surprises Act’s federal arbitration process in 2025.

The staggering amount — far exceeding the previous estimates of IDR’s $5-plus billion price tag — comes amid a drumbeat of investigations, editorials, and warnings, from The New York Times, STAT, Bloomberg, The Washington Examiner editorial board, and most recently, the Congressional Budget Office. All have documented how certain private equity-backed providers and IDR middlemen have turned IDR into a gold rush at the expense of families and employers.

The full Wall Street Journal article is here, and highlights are included below (emphasis added):

  • “A controversial process for arbitrating medical billing disputes awarded nearly $15 billion in payouts to healthcare providers last year, according to new federal data analyzed by The Wall Street Journal, more than triple the total for 2024.”
  • “Doctor groups representing radiologists, anesthesiologists and emergency-room physicians have been among the winners under the setup, which was created under a 2020 law meant to protect patients from surprise medical bills.”
  • “For 2025, total payouts under the arbitration process reached $14.85 billion, according to a Journal analysis of new, previously unreleased data from the Centers for Medicare and Medicaid Services [CMS]. The figure for 2024 was $4.08 billion, according to the analysis.”
  • “‘It’s shocking that it’s rising so fast,’ said Jack Hoadley, a research professor emeritus at Georgetown University’s Center on Health Insurance Reforms.”
  • “‘This law is critical for protecting patients from receiving surprise bills,’ said a CMS spokesman. ‘While patients are now protected from surprise bills, the system is being gamed to get higher prices, and CMS is actively working to clean it up.’ CMS is expected to publicly release the new 2025 data Wednesday.”
  • “In a sign of the provider groups’ success in winning large payouts, the 2025 total was more than six times the amount that would have resulted based on estimates that are supposed to represent typical in-network payment rates, according to the Journal’s analysis.”
  • “The arbitration process is run by private entities certified by the federal government. In 2025, according to CMS, the arbitration entities received about $1.3 billion in fees.”

For more on the costly abuse and misuse of the IDR process, click here.