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
Members of the Coalition Against Surprise Medical Billing, which represent accountable care providers, leading employer groups, and health insurance providers and the tens of millions of people they employ and serve each day, support meaningful solutions to end surprise medical billing that would:
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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; and
- 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 expected 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 growing presence of private equity-backed providers is becoming an all too common influence in the health system—and one of the leading drivers behind egregious surprise medical bills that bankrupt families across the country. Out-of-network providers backed by private equity firms continue to exploit a market loophole that allow them to charge exorbitant rates at patients’ expense. Click Learn More below to view the Coalition’s latest advertising on the harmful tactics from private equity firms and why this practice needs to stop for good.
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.
News
ICYMI: WebMD Highlights Recent Impacts of the No Surprises Act
A recent article from WebMD highlighted the AHIP and Blue Cross Blue Shield Association (BCBSA) survey showcasing the success of the No Surprises Act in protecting patients from out-of-network surprise bills. When the No Surprises Act took effect in January 2022,...
No Surprises Act Prevents More Than 2 Million Surprise Bills Between January and February 2022
Washington, D.C. – A new survey released this week found that the landmark protections in the No Surprises Act (NSA) prevented over 2 million potential surprise medical bills in the first 2 months of 2022. Further, the survey and analysis project that should this...
ICYMI: Providers Seek to Boost Profits at the Expense of Patients
A recent blog post from U.S. PIRG provides an overview of the six [now seven!] lawsuits seeking to undermine the No Surprises Act and how even one court ruling against the legislation could result in the return of physicians sending unexpected out-of-network medical...
Take Action
Tell Washington it’s time to protect patients from surprise and unfair medical bills.