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
Guest Blog: Surprise Medical Billing Protections You Can Use Now
With the No Surprises Act protections fully in effect, consumers and employees will benefit from a range of new safeguards against these unexpected charges and costs. Patricia Kelmar, Director at Health Care Campaigns at U.S. PIRG highlighted a number of these...
Private Equity Is At It Again: New CBO Report Shows Rapid Increases in Hospital and Physician Prices for Consumers and Employers
New evidence from the Congressional Budget Office (CBO) shows that the prevalence of surprise medical billing by private equity-backed doctors and hospitals is a prime example of providers exploiting their market power to demand higher prices from health insurance...
Coalition Statement on AMA and AHA’s Legal Challenge to the No Surprises Act
Following the legal challenge filed by the American Medical Association (AMA) and the American Hospital Association (AHA) today in the U.S. District Court for the District of Columbia on the rulemaking process for the No Surprises Act, the Coalition Against Surprise...
Take Action
Tell Washington it’s time to protect patients from surprise and unfair medical bills.