
Surprise! Surprise! No Surprises Act Favors Providers And Is Driving Up Costs
Since the No Surprises Act (NSA) was passed in late 2020, I have argued that the baseball-style arbitration process is heavily stacked against health plans and favors providers. The law went into effect on January 1, 2022, with some portions still forestalled by the federal government. But the main components that stop surprise billing to patients and the process to settle what is paid by plans to providers has been in force now for about 2 years. The implementation of the arbitration has been rocky. The number of cases is demonstrably above what was expected. That said, more and more data is now available that shows how well providers are doing from the process. In commercial coverage, the main component of the law disallows providers from billing patients for out-of-network services beyond plan outlined in-network cost-sharing for emergency situations, post-emergency stabilization, and non-emergency in-network facility-based procedures where non-network services may