Doctors Attack Pallone Plan to Scrap $16 Billion Billing Arbitration
Updated
Updated · POLITICO · Oct 9
Doctors Attack Pallone Plan to Scrap $16 Billion Billing Arbitration
3 articles · Updated · POLITICO · Oct 9
Summary
Rep. Frank Pallone’s new Lower Premiums, Faster Payments Act would replace No Surprises Act arbitration with payment at the median in-network rate for out-of-network emergency care.
Doctors and a lobbyist involved in the talks say that benchmark would strip providers of leverage in contract negotiations and let insurers push reimbursement rates lower across the board.
Pallone is targeting an arbitration system that handled 2.6 million disputes last year—far above the 22,000 Congress expected—and drove costs above $16 billion, more than triple 2024 spending.
Insurers and employers backed the bill on Thursday, arguing the current process is being abused and that tying payments to market-based rates would curb premiums and clear backlogs.
The fight revives a core dispute from the 2020 No Surprises Act: patients have been protected from surprise bills, but providers, insurers and lawmakers still clash over how out-of-network payments should be set.