The Solution
The No Surprises Act has already made a major difference—preventing more than one million surprise bills each month from health care facilities, providers, and air ambulances. But this progress is at risk. Ongoing lawsuits and loopholes have opened the door for some providers and middlemen to exploit the system, driving up costs and undermining the law’s intent. To preserve the full benefits of the No Surprises Act, policymakers must keep patients at the center—maintaining strong protections, ensuring a fair and transparent process, and closing gaps that allow bad actors to abuse the system. By doing so, we can lower health care costs and uphold the law’s promise of affordability and security for patients and families.
To view the Coalition’s principles, click here.

Latest News
$5 Billion and Counting: How the No Surprises Act’s Arbitration Process is Driving Up Health Care Costs
A new Health Affairs article from Georgetown University’s Center on Health Insurance Reforms reveals how the Independent Dispute Resolution (IDR) process under the No Surprises Act has veered sharply off course, driving $5 billion in wasteful health care spending that...
The Hidden Middlemen Driving Up Health Care Costs: How Revenue Cycle Managers Are Undermining the No Surprises Act
The No Surprises Act protects patients from unexpected out-of-network (OON) medical bills, but a growing industry of profit-seeking middlemen is exploiting loopholes in the system—driving up costs and threatening patient access to care, according to new research...
Guidehouse as an IDR Entity Would Be Akin to Letting the ‘Fox Guard the Hen House’
The Coalition Against Surprise Medical Billing (CASMB)—representing leading employer groups, unions and health insurance providers—sent a letter to the Trump administration strongly opposing Guidehouse, Inc.’s petition to become a Certified Independent Dispute...