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A new tactic in the war over out-of-network bills: Health care providers are suing employers
Executive Summary
AI-generatedHealth care providers are escalating their legal strategies by targeting employers, rather than solely suing insurance companies, over unpaid out-of-network medical bills. This shift is driven by the arbitration process established under the No Surprises Act, where providers are frequently winning high-value awards. This trend is introducing new financial pressure on businesses and contributing to rising health insurance premiums for workers.
Key Insights
- Health care providers are moving from targeting insurers to suing employers, claiming employers are responsible for unpaid arbitration awards.
- The lawsuits stem from the No Surprises Act, which uses arbitration to determine payment for out-of-network emergency care.
- This new litigation tactic forces employers to incur direct expenses related to their health care plans.
- Georgetown University researchers estimate that high payments resulting from this process have added approximately $20 billion in costs to the health care system.
- PHI Health is highlighted as one of the most aggressive companies utilizing this strategy, filing suits against hundreds of companies.
Topic context
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