Your Surprise Medical Bill May Be Gone — But Your Premiums Could Still Spike

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By Andria Park Huynh HealthDay Reporter

Medically reviewed by Carmen Pope, Senior Medical Editor, B. Pharm. Last updated on June 1, 2026.

via HealthDay

MONDAY, June 1, 2026 — A new federal rule may unintentionally make it easier for health care providers to game the system, potentially raising health insurance costs for Americans.

The final rule issued Thursday tweaks the No Surprises Act, which went into effect for most people in 2022. The rule aims to improve communication between payers and providers while giving Medicare more visibility into their negotiations, according to STAT.

Other changes allow providers to bundle up to twice as many insurance claims (from 25 to 50) into a single dispute. The plan also streamlines the process for determining eligibility for certain services, according to the Centers for Medicare & Medicaid Services.

While insurers, providers and consumer advocates praised the Trump administration's tweaks to the arbitration process (informally known as IDR), some said the changes don't address overuse by providers, which is costing millions.

“It does make meaningful progress to reduce burdens and streamline, but we need additional action to address some of the underlying incentives that are driving overuse of the process,” said Jennifer Jones, senior director of legislative and regulatory policy for the Blue Cross Blue Shield Association. “We need more to address the egregious award amounts.”

The final rule slashes the administrative fee for initiating disputes from $115 per case to $15. The money goes to the departments of Health and Human Services, Labor and the Treasury, which oversee the program, STAT reported.

Some have noted that the agencies have collected more in fees than they spent administering IDR. In the first half of 2025, they spent $44.5 million of the $230.5 million collected, leaving $186 million on the table, STAT reported.

A consumer advocate warned that lower filing fees might encourage providers to overwhelm IDR with disputes.

Anthony Wright, executive director of the consumer advocacy group Families USA, said disputes could increase by up to 30%, according to STAT.

“That overwhelming surge is being driven by certain providers, and particularly those backed by private equity, who have found ways to game the system and secure payment several times higher than what they would have received by negotiating with insurers directly,” he said in a statement. “This final rule fails to stop these abuses, which threaten to further increase health insurance premiums.”

The No Surprises Act was enacted in 2020 to protect patients from sky-high bills for seeing out-of-network providers. But it is adding costs to a system in which providers come out on top in more than 80% of disputes.

“Those costs go somewhere and ultimately make their way into higher patient costs,” said Jones, who doesn’t expect a substantial reduction in ineligible claims. “As we all look at the affordability challenges with health care today, this feels like something we can fix.”

Sources

  • STAT, June 1, 2026

    • Disclaimer: Statistical data in medical articles provide general trends and do not pertain to individuals. Individual factors can vary greatly. Always seek personalized medical advice for individual healthcare decisions.

    Source: HealthDay

    Posted : 2026-06-02 00:30

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