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
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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.
- 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 expect 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 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: 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...
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...
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Tell Washington it’s time to protect patients from surprise and unfair medical bills.