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Lower Premiums, Faster Payments Act Targets Arbitration Loopholes in Surprise-Billing Law
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Legislative Proposal to Reform Surprise Billing Arbitration
Representative Frank Pallone Jr., the top Democrat on the House Energy and Commerce Committee, has introduced the Lower Premiums, Faster Payments Act. The bill would amend the 2020 No Surprises Act by replacing its arbitration mechanism with a “benchmarking” system that pays out-of-network providers at the median in-network rate, adjusted for geography, and requires payment within 30 days of filing a claim.
Background: How the No Surprises Act’s Arbitration Works
The No Surprises Act eliminated surprise out-of-network bills for patients by creating an arbitration process for payment disputes between insurers and providers. Critics argue the process has become a venue for “bad actors”—largely private-equity-backed groups that own anesthesiology, radiology, and emergency-room practices—to secure inflated payments.
Financial Impact of the Current Arbitration System
- In 2025, 2.5 million disputes were submitted, with ? 67 % filed by just ten provider groups.
- Fifteen arbitration firms collected $1.3 billion in fees in 2025, up from the $885 million they earned between 2022-2024.
- Those firms awarded providers nearly $15 billion in 2025, a cost that feeds higher premiums.
- A Health Affairs analysis attributes $22.4 billion in total costs over four years to the arbitration process.
- The New York State Employee Plan identified arbitration awards as the primary driver of a 10 % premium increase in the most recent year.
Official Statements & Responses
Pallone, a co-author of the original No Surprises Act, acknowledges the law’s success in shielding patients from surprise bills but says the arbitration component “is clearly not working.” Anthony Wright, executive director of the consumer-advocacy group Families USA, calls for congressional action to close the loopholes that allow “private-equity-backed and corporate firms” to secure inflated payments, which he says push premiums upward. Both officials frame the proposed benchmarking approach as a market-based fix that would keep providers fairly compensated while preventing cost inflation for consumers.
Verbatim Quotes
- “The No Surprises Act has been an overwhelming success when it comes to protecting patients from surprise medical bills,” — Ranking Member Frank Pallone
- “The No Surprises Act has been an overwhelming success when it comes to protecting patients from surprise medical bills. Prior to the law, millions of Americans were on the hook for surprise bills and caught in the middle of payment disputes,” — Ranking Member Pallone
- “To help make health care more affordable, Congress needs to close the loopholes in existing law that private equity-backed and corporate firms are exploiting to secure inflated payments — loopholes that ultimately push premiums ever upward,” — Anthony Wright, Executive Director of Families USA