CMS Says Doctors Gamed Surprise Billing Law as 2025 Payouts Hit $14 Billion
Updated
Updated · The New York Times · Jul 22
CMS Says Doctors Gamed Surprise Billing Law as 2025 Payouts Hit $14 Billion
1 articles · Updated · The New York Times · Jul 22
Summary
$14 billion in doctor payouts flowed through the No Surprises Act in 2025, CMS said, more than triple 2024's $4 billion.
CMS said out-of-network doctors and billing firms are exploiting the law's arbitration system to win higher payments, and the Trump administration is weighing reforms to curb the practice.
The 2020 law largely shielded patients from surprise emergency bills, but it also opened a dispute-resolution channel that has produced outsized awards for some providers.
New York Times reporting cited extreme cases including $440,000 for one breast-reduction operation and $196,566 for assisting a scoliosis surgery, underscoring the stakes of any overhaul.