Updated
Updated · The New York Times · Jul 22
Trump Administration Targets Surprise Billing System as Doctor Payouts Near $15 Billion
Updated
Updated · The New York Times · Jul 22

Trump Administration Targets Surprise Billing System as Doctor Payouts Near $15 Billion

1 articles · Updated · The New York Times · Jul 22

Summary

  • $15 billion in doctor payouts flowed through the No Surprises Act arbitration system in 2025, up from $4 billion in 2024, according to new CMS data released Wednesday.
  • CMS said some doctors and billing firms are exploiting the dispute process to win higher out-of-network payments, and a spokesman said the agency is working to clean up the system.
  • The 2020 law largely shielded patients from surprise emergency bills by sending payment fights between insurers and out-of-network doctors to federal arbitration.
  • New York Times reporting has highlighted unusually large awards under that system, including $440,000 for one breast reduction case and $196,566 for assisting a scoliosis surgery.

Insights

With medical dispute payouts hitting $14 billion, are doctors exploiting the system or finally getting paid what they're owed?
The government just overhauled its medical billing dispute system. Will this finally lead to lower health insurance premiums for Americans?