‘Fox Guarding the Hen House’ Leading to Abuse of IDR Process at Americans’ Expense
Washington, D.C. – As abuse and misuse of the No Surprises Act continues from some private equity-backed and out-of-network providers, a new ad campaign highlights how misaligned incentives create a ‘fox guarding the hen house’ dynamic, allowing bad actors to flood the law’s independent dispute resolution (IDR) process with outrageous, often ineligible claims.
“Judge Fox” — a seven-figure ad campaign from the Coalition Against Surprise Medical Billing (CASMB) — launches today in D.C. amid mounting evidence that some private equity-backed providers and IDR middlemen are relentlessly abusing the IDR process to maximize their own profits at Americans’ expense.
Since the IDR process, also known as arbitration, started in April 2022, the volume of IDR cases has vastly outpaced what Congress anticipated, and some out-of-network providers — including those owned by powerful private equity firms — are winning the overwhelming majority of disputes with extremely high awards, often 3–9 times higher than in-network rates.
Without meaningful guardrails, oversight, or accountability, the IDR process has so far added more than $5 billion in excessive costs that employers and consumers ultimately have to pay. Some private equity firms have compounded the healthcare affordability crisis by controlling and owning providers that flood the system with disputes, many of which are ineligible, while also operating IDR entities that are supposed to independently oversee disputes — having the proverbial fox guard the hen house.
CASMB and its members continue to urge policymakers to rein in these bad actors through enhanced transparency and oversight of IDR entities, private equity-backed providers, and the IDR middlemen flooding the system with ineligible, extreme claims.
To learn more, visit: https://stopsurprisebillingnow.com/arbitration
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