New No Surprises Act arbitration rule may increase provider disputes, critics say

The administration released a final rule on Thursday that tweaks the No Surprises Act arbitration process. The changes are meant to improve communication between insurers and providers and give Medicare greater visibility into their negotiations.

The rule also seeks to limit arbitration to truly eligible disputes and prevent it from being used as a catch‑all solution.

Despite the revisions, health insurers, providers and consumer advocates warn that the rule does not address the underlying provider gaming that has produced millions in windfalls, and could actually increase the volume of disputes.

Jennifer Jones, senior director of legislative and regulatory affairs at Blue Cross Blue Shield, said the rule makes meaningful progress but called for additional steps to curb the incentives driving overuse of arbitration.