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Getting the latest healthcare news for you
Getting the latest healthcare news for you
The No Surprises Act was meant to protect patients from unexpected medical bills, but its dispute resolution process is getting very expensive. A Georgetown University study found total costs hit $22.4 billion by end of 2025 — far beyond initial projections. With 2.6 million disputes filed in 2025 alone (up 77% year-over-year), researchers say it may be time to revisit the law.
The No Surprises Act (NSA) was designed to shield patients from surprise medical bills — but the law's independent dispute resolution (IDR) process has grown into a multi-billion-dollar system that's straining the healthcare economy. A new Georgetown University analysis published in Health Affairs found total costs tied to the IDR process reached $22.4 billion by the end of 2025, with researchers noting their estimate is likely conservative due to unreported internal administrative data.
The surge is being driven by a small number of heavy hitters. Three organizations — Radiology Partners, HaloMD, and TeamHealth — accounted for nearly 75% of resolved disputes, with two of the three backed by private equity. Meanwhile, disputes in specialties like neurology, plastic surgery, and emergency medicine saw dramatic payout increases, with some median awards reaching 24–30 times the qualifying payment amount.
By the Numbers:
Why it matters: These escalating costs don't stay in the system — they get passed on to consumers through higher insurance premiums. Researchers are calling on lawmakers to revisit the NSA to restore its original cost-containment goals while preserving the patient protections that made the law widely supported in the first place.
