Morning Briefing
Summaries of health policy coverage from major news organizations
Doctor Groups Won Big Payouts in 2025 From Medical Billing Arbitration, Analysis Finds
The Wall Street Journal: Medical Billing Arbitration Paid Out $15 Billion To Providers In Surprise Bill Disputes
A controversial process for arbitrating medical billing disputes awarded nearly $15 billion in payouts to healthcare providers last year, according to new federal data analyzed by The Wall Street Journal, more than triple the total for 2024. Doctor groups representing radiologists, anesthesiologists and emergency-room physicians have been among the winners under the setup, which was created under a 2020 law meant to protect patients from surprise medical bills. Insurers have to make the awarded payouts, and they have generally ended up on the losing end since arbitration began four years ago. (Mathews and McGinty, 7/22)
The New York Times: Trump Administration Says Surprise Billing Law Is Being ‘Gamed’ By Doctors
For the first time, officials have acknowledged problems with the No Surprises Act, which has led to huge payments. (Kliff, Sanger-Katz and Parlapiano, 7/22)
Modern Healthcare: CMS Falls Behind On No Surprises Act Billing Disputes
The Centers for Medicare and Medicaid Services and its contractors can’t keep up with the ceaseless onslaught of No Surprises Act out-of-network billing cases, federal data show. Providers and health insurance plans initiated 1.43 million Independent Dispute Resolution arbitrations this year through May, 46% more than during the comparable period in 2025. The system resolved 1.36 million cases over those five months. (Tepper and Broderick, 7/22)
In Medicaid developments —
Healthcare Dive: CMS Moves To Codify Limits On Medicaid Provider Taxes
The new proposed rule is meant to prevent states from guaranteeing providers will be refunded for their taxes, and should save Washington $246 billion over the next decade, regulators said. (Parduhn, 7/22)
The Colorado Sun: Colorado Medicaid Owes Feds $8 Million, Audit Finds
The federal government wants Colorado to return $8 million in Medicaid funding after accusing the state of misspending money on an in-home care program for people with disabilities. (Brown, 7/22)
On the price of insulin —
The Hill: Senate Committee Advances $35 Insulin Cap For Private Insurance Holders
Bipartisan legislation to cap the cost of insulin at $35 for people with private health insurance advanced through a key Senate committee Wednesday, but its future remains uncertain. (Weixel, 7/22)
In Medicaid developments —
Bloomberg: Retiree Health Costs Spike 7.5% In Latest Estimate From Fidelity
People retiring this year can expect medical expenses to take a significantly bigger bite of their savings, according to a new report from Fidelity Investments. (Woolley, 7/22)
KFF Health News: Listen To The Latest ‘KFF Health News Minute’
Jackie Fortiér reads this week’s news: Coverage disruptions can have fatal consequences when switching health plans. Plus, more states are shaming employers that use your tax dollars to cover health costs for their low-income workers. (7/23)
