Medscape August 23, 2024
Randy Dotinga

Four organizations owned by private equity firms — including two provider groups — dominated the No Surprises Act’s disputed bill arbitration process in its first year, filing about 70% of 657,040 cases against insurers in 2023, a new report finds.

The findings, recently published in Health Affairs, suggest that private equity-owned organizations are forcefully challenging insurers about payments for certain kinds of out-of-network care.

Their fighting stance has paid off: The percentage of resolved arbitration cases won by providers jumped from 72% in the first quarter of 2023 to 85% in the last quarter, and they were awarded a median of more than 300% the contracted in-network rates for the services in question.

With many more out-of-network bills...

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Topics: Provider, Survey / Study, Trends
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