No Surprises Act shielded patients from big medical bills. Now its arbitration system may be raising costs.

Updated on: October 7, 2026 / 12:22 PM EDT / CBS News

A law designed to protect patients from surprise medical bills succeeded in eliminating unexpected charges, but spawned a lucrative arbitration industry with providers and specialized middlemen extracting payments far above benchmark billing rates.

The practice is ultimately driving up healthcare costs for consumers, a CBS News investigation found.

The arbitration system Congress created to settle disputes between insurers and out-of-network providers allows doctors and resolution specialists acting on their behalf to win payments many times higher than typical rates for medical services. Those costs don't disappear: Much of the money comes from employer-sponsored health plans, meaning workers may ultimately pay through higher premiums or reduced benefits.

Under the arbitration system established by the No Surprises Act, which took effect in 2022, insurers are paying healthcare providers hundreds of dollars for routine lab tests that typically cost between $10 and $30, industry researchers told CBS News. In one instance, a plastic surgeon was awarded more than $400,000 to perform a breast reduction, a procedure the insurer said it had previously paid the doctor between $6,000 and $30,000 to perform.

The plastic surgeon, Dr. Norman Rowe, routinely was awarded around…

Original source: https://www.cbsnews.com/entertainment/