AHIP survey shows No Surprises Act protected Americans from 10M surprise bills - Insurance News | InsuranceNewsNet

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January 29, 2024 Health/Employee Benefits News
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AHIP survey shows No Surprises Act protected Americans from 10M surprise bills

By Press Release

WASHINGTON, D.C. – (January 29, 2024) – During the first nine months of 2023, the No Surprises Act protected Americans from more than 10 million surprise medical bills, according to a new survey by AHIP and the Blue Cross Blue Shield Association.

The AHIP and BCBSA survey found that the NSA prevented more than 10 million surprise medical bills from health care facilities, providers, and air ambulance providers from reaching patients. Another key finding from the study—67% of health insurance providers indicated that they increased their provider networks since the enactment of the NSA, with no plans reporting decreases in provider networks.

The NSA is working for the vast majority of health insurance and health care providers. In fact, for almost 80% of NSA-eligible claims resolved without the use of the Independent Dispute Resolution (IDR) process—a negotiating process intended for use in limited circumstances—providers accepted the initial payment offered by health insurance providers. However, the AHIP and BCBSA research found a growing and troubling trend—the skyrocketing use of IDR.

Before the law took effect, federal agencies estimated that 17,000 claims would go through the IDR process annually. In fact, between April 15, 2022, and March 31, 2023, 334,828 disputes were initiated through the IDR portal, nearly fourteen times greater than the initial estimate. This increase in the use of the IDR process suggests that certain providers and hospitals may be attempting to exploit the arbitration process solely to increase profits.

AHIP and BCBSA fielded the survey nationwide in November 2023 to a diverse group of health insurance providers (commercial market, self-funded group health, fully-insured group health plans, individual market coverage). It was distributed to 80 health insurance providers. Twenty-one health insurance providers, representing 65% of the total commercial market, responded to the survey via an online tool.  

 

Please click here to view and download the survey results.

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