No Surprises Act shielded patients from big medical bills. Now its arbitration system may be raising costs.
Updated on: October 7, 2026 / 1:21 PM EDT / CBS News
TL;DR
- The No Surprises Act, designed to protect patients from surprise medical bills, has led to a lucrative arbitration industry.
- Providers and specialized middlemen are extracting payments significantly higher than benchmark billing rates through this arbitration system.
- The increased costs are ultimately driving up healthcare expenses for consumers, potentially through higher premiums or reduced benefits from employer-sponsored health plans.
- Arbitration awards have been seen to be hundreds of dollars for routine lab tests, compared to typical costs of $10-$30.
- Some providers have been awarded payments vastly exceeding previous rates for procedures, with arbitration siding with providers in over 85% of cases.
- The arbitration system, intended to resolve disputes, has seen an unexpectedly high volume of cases submitted.
- Private equity firms are implicated in driving arbitration cases, with some owning both physician staffing firms and dispute resolution entities, creating potential conflicts of interest.
- Proposed reforms aim to eliminate the arbitration process and mandate in-network rates for providers, regardless of their network status.