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Private Equity Wins, Patients Lose in New Senate Surprise Billing Legislation
WASHINGTON — After years of certain private equity-backed providers scamming patients with costly surprise medical bills, new legislation S.2420 introduced in the Senate would add even greater costs for employers, health plans and patients. CASMB members and allies,...
Nutex Health Saw Financial Upside “Exploiting” the Arbitration Process & Exposed A New Surprise Billing Business Model
While the No Surprises Act successfully protects patients from unexpected medical bills, Nutex Health’s approach reveals how the law’s arbitration process, also known as the Independent Dispute Resolution (IDR), can be exploited for financial gain. The implications...
ICYMI: Arbitration Roulette—When Outcomes Depend on the Arbitrator, Not the Facts
A new Health Affairs article published by researchers at Georgetown University’s Center on Health Insurance Reforms and released as a companion article to an earlier analysis, highlights alarming inconsistencies in how arbitrators are resolving payment disputes under...
ICYMI: Private Equity-Backed Providers and Profit-Enhancing Middlemen Have Made Manipulating the IDR Process a Business Model
Certain health care providers—particularly large, private equity-backed groups—are increasingly dominating the federal Independent Dispute Resolution (IDR) process established under the No Surprises Act, according to new data from the Centers for Medicare &...
CASMB Urges the Trump Administration to Fix Costly Arbitration Process That Threatens to Undermine No Surprises Act
WASHINGTON, DC – Unnecessary and wasteful costs from the federal arbitration process continue to add up for employers, unions and health plans as certain providers continue to overuse and likely misuse the system, according to a new letter to the Trump-Vance...
When Red Tape Comes with a Hefty Price Tag
While the No Surprises Act is successfully safeguarding patients from surprise medical bills, some providers are flooding the independent dispute resolution (IDR) process with ineligible claims, driving up costs for patients, employers, and the broader health care...
Ineligible Claims From Some Providers Creates Significant Arbitration Bottleneck
While the No Surprises Act has successfully prevented approximately 1 million surprise medical bills per month from health care facilities, providers, and air ambulances, certain providers are flooding the federal arbitration process—also known as the independent...
Surprise, Surprise – Some Providers Are Still Surprise Billing Patients Despite Federal Ban
New data from the Center for Medicare & Medicaid Services (CMS) on implementation of the No Surprises Act (NSA) found that some providers are still attempting to balance bill patients and continue to submit ineligible, incomplete, or incorrect claims to the...
CASMB Urges Trump Administration To Fix Flawed Arbitration Process
Before the passage of the No Surprises Act, too many patients experienced the costly burden of surprise medical bills. President Trump signed this landmark law in December 2020, and since it took effect in January 2022, it is preventing approximately 1 million...
ICYMI: New Analysis from Brookings Underscores How Private Equity Is Overwhelming Arbitration
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...