Surprise Billing Arbitration Rule Risks Higher Health Premiums

The Biden administration’s final rule governing how arbitrators are instructed to decide payment disputes between health insurers and medical providers over “surprise bills” may result in higher costs for health insurance plans, researchers and employer groups said.

The measure opens the door to higher costs for employers and their workers because it instructs arbitrators to give more consideration to factors beyond median contract rates, they said.

The final rule (RIN 1210-AB99 and 1210-AC00) implements a law aimed at keeping patients from being billed high charges in emergencies and when out-of-network providers furnish services at patients’ network medical facilities. It ...