A payer-backed group has launched a campaign challenging a bill that would build on the No Surprises Act.
The Coalition Against Surprise Medical Billing (CASMB) announced on Monday that its "six-figure" campaign urges lawmakers to reject the No Surprises Act Enforcement Act, or H.R. 4710. This legislation, they argue, would "reward the actors misusing the [independent dispute resolution] process."
Payers and providers have been at odds over the IDR process, with insurers arguing that it's being flooded in a bid to secure higher payments for out-of-network bills. An April investigation in the New York Times highlights IDR abuse, CASMB notes in a press release, while a report released by the Blue Cross Blue Shield Association and AHIP in October 2025 suggests 39% of claims submitted to IDR were not eligible.
H.R. 4710 would add new fines for employers or insurers for delays in final payment adjustments and fails to acknowledge the trend of IDR "flooding" and the third-party organizations that have arisen to support it, CASMB argues.
The bill also does not address the "misaligned incentives" that drive IDR abuse. Providers are overwhelmingly likely to win if a dispute reaches IDR, with their proposed rates selected in 87% of disputes in Q2 2025 alone.
In one ad under the campaign, it highlights how the IDR process has been used to increase reimbursement for surgical assistants, offering an example of a surgeon earning $1,843 for a procedure while the assistant earned $50,000 through arbitration.
The ad says that the No Surprises Act was passed "with good intentions," but that Congress should focus future efforts on closing loopholes that allow for IDR abuse.
Members of CASMB include AHIP, BCBSA, the ERISA Industry Committee, the Business Group on Health, the Purchaser Business Group on Health and a slew of regional employer groups. A number of these organizations and leading employers sent a letter (PDF) last week, telling key representatives that the bill would "exacerbate the affordability crisis."
"This landmark law was intended to protect patients from surprise medical bills and lower health care costs," they wrote. "While the law has protected patients from the immediate cost of surprise medical bills, implementation of the law has fallen far short of the equally important goal of making health care more affordable."
"Instead, the profit-driven use of the IDR process by certain provider groups and middlemen is causing health care costs to spiral even higher, and employers, working families, patients and consumers are paying the price," they said in the letter.