Providers win the overwhelming majority of claim disputes under the No Surprises Act, prevailing 85% of the time in 2024, up from 81% in 2023, according to data recently published in Health Affairs. The data also show providers are winning substantial offer amounts—a median of 445% of the qualifying payment amount in 2024 (i.e., about 4.5 times what the insurer’s in-network equivalent would have paid), up from a median 327% in 2023. The data show the law’s arbitration mechanism incurring substantial costs—an estimated $5 billion from 2022 to 2024. The volume of disputes has exceeded expectations, and many go unresolved within required timeframes. These data demonstrate that the arbitration process is more costly and litigious than anticipated.
