# Surprise billing arbitration costs

Lifestyle · Heat 1.0 / 10 · 2 shows · 7m airtime

Congress passed the No Surprises Act on December 27, 2020, creating arbitration to keep patients out of billing fights between doctors and insurers. Reporting in October 2026 found the costs landing on employers and public plans: Clark County, Nevada teachers' arbitration fees rose from 7% to 25% of what the plan paid for emergency care, San Antonio is $40 million over budget, and New York state employees face a 10% premium hike. Arbitrators pick higher-priced doctor bids 85% of the time. Pallone now proposes eliminating arbitration and paying doctors at median in-network rates; Murphy and Cassidy say bills are coming.

Page: https://boilpoints.com/point/surprise_billing_arbitration_costs_2578583148

## Segments

- [Marketplace](https://boilpoints.com/u/marketplace), 2026-10-09, 12:34 to 17:15: **Reports arbitration costs hitting public plans**. Reports from Clark County, San Antonio and New York on how No Surprises Act arbitration costs are landing on employers and public plans, and on direct contracts some doctors' groups are striking to bypass the process. New angle: Arbitration fees for Clark County teachers' emergency care rose from 7% to 25% of what the plan was paying.
- [What the Health? From KFF Health News](https://boilpoints.com/u/whatthehealthfromkffhealthnews), 2026-10-15, 9:34 to 12:14: **Previews the lame duck surprise billing fix**. Turns to the lame duck session and the No Surprises Act fix talk: Pallone's proposal to scrap arbitration for median in-network rates, Murphy saying Ways and Means will move legislation, and Cassidy promising a bill. The first concrete legislative path on the record. New angle: Pallone proposes eliminating arbitration and paying doctors at median in-network rates; Murphy and Cassidy say bills are coming.