Administration Says Surprise Billing Law Is Being ‘Gamed’ by Doctors

[intercst]

To be more accurate, it’s being gamed by the Private Equity operators who bought out the doctors.

free link:

https://www.nytimes.com/2026/07/22/upshot/doctors-huge-payments-trump.html?unlocked_article_code=1.0FA.hLlg.f36zGz_Eeh6N&smid=url-share

{{ Under the system, each side submits its final offer to an independent arbitrator who picks the most reasonable one. Compromise awards are not permitted, and appeals are not allowed. In one case The Times reported, an arbitrator had to decide between offers of $105 and $100,000 for work assisting in a breast reconstruction surgery. The arbitrator selected the doctor’s bid. }}

Yep. United Heathcare said it was worth $100, the Private Equity firm said $100,000. I’m guessing the Medicare reimbursement for the procedure was probably about $5,000.

Which of these unsympathetic supplicants to choose ???

Single Payer would eliminate this nonsense.

intercst

[RedCloud1]

It seems to me that both sides are trying to game the system: the insurance companies providing absurdly low estimates and the doctor/PE providing absurdly high estimates. The insurance companies are losing, at least some cases. However, I suspect that they’ve already run the numbers and have found that they profit overall from such low estimates and can accept the losses from high bids. If they hadn’t, they would submit reasonable estimates in line with reality.