Payer-Backed Coalition Campaigns Against Proposed No Surprises Act Expansion
A payer-backed group has launched a campaign against a bill designed to expand the No Surprises Act, capturing the attention of stakeholders across the healthcare sector.
CASMB’s Campaign Against H.R. 4710
The Coalition Against Surprise Medical Billing (CASMB) announced on Monday its “six-figure” campaign aimed at urging lawmakers to reject the No Surprises Act Enforcement Act, or H.R. 4710. CASMB argues that this legislation would “reward those actors who abuse the law” through the independent dispute resolution (IDR) procedure.
Debate Over the IDR Process
The IDR process has been a contentious point between payers and providers. Insurers argue that the system is being overwhelmed by providers seeking higher payments for out-of-network bills. An investigation by The New York Times in April highlighted instances of IDR abuse, and CASMB cites this in their press release. Furthermore, a report from the Blue Cross Blue Shield Association and AHIP published in October 2025 suggests that 39% of claims filed with IDR were not legitimate.
Potential Implications of H.R. 4710
CASMB contends that H.R. 4710 would impose new penalties on employers or insurers for delays in adjusting final payments without addressing the issue of IDR “flooding” and the third-party organizations that have emerged to support it. The bill also fails to tackle the “perverse incentives” driving IDR abuse, according to CASMB. Providers reportedly have a high success rate in IDR, with their proposed rates being selected in 87% of disputes in Q2 2025 alone.
Highlighting Reimbursement Discrepancies
An advertisement from the campaign underscores how the IDR process has been manipulated to increase reimbursement for surgical assistants, providing an example of a surgeon earning $1,843 for a procedure while the assistant earns $50,000 through arbitration.
The Call for Closing Loopholes
The advertisement emphasizes that while the No Surprises Act was passed “with good intentions,” Congress should direct future efforts towards closing loopholes that allow for IDR abuse. CASMB’s members—including AHIP, BCBSA, the ERISA Industry Committee, the Business Group on Health, the Purchaser Business Group on Health, and numerous regional employer groups—have voiced concerns.
Concerns Over Healthcare Affordability
These organizations, along with leading employers, sent a letter last week to key officials arguing that the bill would “exacerbate the affordability crisis.” They stated, “This groundbreaking law should protect patients from surprise medical bills and reduce healthcare costs. While the law protects patients from the immediate costs of surprise medical bills, the implementation has fallen short of making healthcare more affordable.” The letter further argues, “Instead, the for-profit use of the IDR process by certain provider groups and intermediaries causes healthcare costs to skyrocket, with employers, working families, patients, and consumers paying the price.”
The ongoing debate highlights the complex interplay between legislative efforts to protect patients and the financial mechanics of the healthcare system. As this discussion unfolds, stakeholders from all sides continue to weigh the potential impacts of proposed changes to the No Surprises Act.
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