Margot Sanger-Katz predicts the number of arbitration cases under the No Surprises Act will continue to rise and proliferate nationwide.

In the first half of 2023 alone, more than one million claims were brought to arbitration under the No Surprises Act, far exceeding initial government estimates.

Under the No Surprises Act arbitration system, some gynecologists have been paid 600 times the average price for placing IUDs.

In the last quarter for which data is available, doctors won 88% of arbitration cases under the No Surprises Act.

Insurers have filed approximately 20 lawsuits across the United States against medical practitioners they accuse of exploiting the No Surprises Act arbitration process.

Margot Sanger-Katz believes there is currently limited appetite in Congress to amend the No Surprises Act because the core consumer problem of patients receiving surprise bills has been solved.

The insurer Emblem Health, which sued Dr. Norman Rowe, has an average price of less than $10,000 for the same breast reduction procedure for which he was paid $440,000.

Federal officials initially estimated that 17,000 disputes would be decided through arbitration annually under the No Surprises Act.

The growth in arbitration cases is being driven by new "middleman" firms that specialize in managing the complex administrative process for doctors.

Doctors successfully sued the Biden administration in a Texas court, overturning guidance that instructed arbitrators to prioritize the average in-network price when deciding payment disputes.

Prior to the No Surprises Act, surprise medical bills for patients could amount to thousands or tens of thousands of dollars.

Doctors and private equity firms that finance medical practices spent approximately $50 million on lobbying and advertising to influence the surprise billing legislation.

Dr. Norman Rowe, a plastic surgeon in the New York metro area, received payments of $440,000 for breast reduction surgeries through the No Surprises Act arbitration process.