A new study from the Elevance Health Public Policy Institute finds that arbitration awards for certain planned medical procedures under the No Surprises Act are often tens to hundreds of times higher than typical in-network payment rates. The research examined more than 7,300 payment disputes involving scheduled services such as spine surgery, plastic surgery, and colonoscopy, where providers won nearly 90 percent of disputed claim lines. The average independent dispute resolution award was nearly $40,000, compared with benchmark rates ranging from approximately $645 to $1,600, and the median award was more than 50 times the median in-network contracted rate for the same service in the same market. Awards for these procedures increased 43 percent between 2024 and 2025. The study raises concerns that the dispute resolution process is being used for scheduled services in ways that diverge from the law's original intent, contributing to higher healthcare costs for employers and families.
Elevance Health IncStudy finds arbitration awards far exceed in-network rates, raising concerns about higher healthcare costs, which could lead to regulatory scrutiny or policy changes affecting Elevance Health.