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
Employers, Health Plans Oppose Legislation to Make Arbitration More Costly for Consumers
While the No Surprises Act took a critical step in banning unfair, egregious surprise medical bills, certain private equity-backed providers continue to abuse and misuse the law’s arbitration process (also known as independent dispute resolution, or IDR) as a “back...
Four Provider Organizations Are Abusing and Misusing Arbitration. Employers, Patients, and Families are Paying the Price
Prior to the passage of the No Surprises Act, certain private equity-backed health care providers designed an entire business model around strategically exiting health plans’ networks as a way to maximize out-of-network reimbursements at the expense of patients,...
ICYMI: How Private Equity Is Gaming the No Surprises Act
Researchers at Georgetown University’s Center on Health Insurance Reform recently analyzed new data from the Centers for Medicare & Medicaid Services (CMS) detailing arbitration outcomes from all of 2023 under the No Surprises Act. While the law has been effective...
Take Action
Tell Washington it’s time to protect patients from surprise and unfair medical bills.