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
The one word you don’t want to hear during anesthesia: Surprise
In the latest example of surprise medical billing gone very wrong, patients who require anesthesia for elective procedures – from dental fixes to more complex surgeries – often learn days after that they are victims of a surprise bill. According to a recent report...
Air Ambulance Companies Prove The Sky Isn’t The Limit When It Comes to Surprise Billing
How it started: Brookings – High air ambulance charges concentrated in private equity-owned carriers (October 13, 2020) “…rapid growth in air ambulance prices is borne by consumers both through higher insurance premiums and more directly through cost-sharing and...
Want to Lower Premiums for Millions of Americans? Ending Surprise Medical Billing Will Do Just That
When out-of-network providers and private equity firms take advantage of patients, we all pay the price. Now, new research from the USC-Brookings Schaeffer Initiative for Health Policy shows clearly how this exploitative practice ends up costing the country billions...
Take Action
Tell Washington it’s time to protect patients from surprise and unfair medical bills.