Industry
No Surprises Act Dispute Resolution Costs Reach $22B, Georgetown Finds
New Georgetown University research found that independent dispute resolution under the No Surprises Act has generated $22 billion in additional healthcare costs, driven by accelerating dispute volumes and high arbitration award amounts. The researchers warn that these costs could translate into higher health insurance premiums for consumers. The No Surprises Act, which took effect in 2022, established a federal arbitration process for out-of-network billing disputes but does not apply to Medicaid managed care plans, which operate under different surprise billing protections.
Why it mattersWhile the No Surprises Act does not apply to Medicaid managed care, the cost pressures it creates in commercial insurance markets could affect premium rates for dual-eligible special needs plans and influence state decisions about managed care rate structures.