Rep. Frank Pallone Jr., D-N.J., one of the authors of the No Surprises Act, is introducing legislation that would replace the law’s arbitration process with a payment benchmark based on the median in-network rate.
The Lower Premiums, Faster Payments Act would amend the 2020 law and require payment within 30 days of a claim being filed, according to an Oct. 8 news release. Mr. Pallone is ranking member of the House Energy and Commerce Committee.
Mr. Pallone said the current law has protected patients from surprise medical bills but that its independent dispute resolution process is failing.
“A few bad actors — largely backed by private equity — are gaming the system, creating backlogs, delaying payments and driving up premiums,” he said.
According to committee Democrats, 10 provider groups submitted about 67% of the 2.5 million disputes filed in 2025. Fees tied to the arbitration process reached $1.3 billion last year, compared with $885 million across 2022 through 2024 combined, and the 15 certified arbitration firms awarded nearly $15 billion to providers.
The release points to court decisions that weakened the law’s payment guidelines, which led to larger awards. It also cites a Health Affairs analysis finding that the arbitration process contributed to an estimated $22.4 billion in total No Surprises Act costs over four years. The New York State Employee Plan named arbitration awards as the main driver of its 10% premium increase this year.
