Surprise bills

Read it this way The projected-volume line sits flat near the bottom while initiated and closed disputes both climbed into the millions by 2024, more than eighty times the original 17,000-a-year estimate. The caveat notes that only in the first half of 2025 did closures begin exceeding new filings, meaning the backlog was still growing, not shrinking, over the years plotted here. Use this chart to see whether the law is protecting patients, shifting disputes, or creating administrative load, and why the recommendation preserves the shield while improving the back-end process.

Caveat The 2024 initiated figure is CRS's rounded count of more than 1.46 million. In the first half of 2025, closures (1,349,343) already exceeded new filings (1,186,812) as the backlog began to clear.

CMS and Congressional Research Service, Federal IDR data · 2024 · source

Read it this way Both bars clear the 33-business-day statutory target, and air-ambulance disputes take close to three times as long as the median case. The caveat that roughly two-thirds of 2025 determinations still exceeded the requirement suggests this is a persistent pattern, not a one-time backlog. Use this chart to see whether the law is protecting patients, shifting disputes, or creating administrative load, and why the recommendation preserves the shield while improving the back-end process.

Caveat In 2025 roughly two-thirds of determinations still exceeded the 30-business-day requirement.

CMS, Federal IDR data · 2024 · source

Read it this way The provider line rises every period while the insurer line falls by the same amount, a mirror-image trend showing the shift is one-directional rather than fluctuating. This chart alone does not explain why; that context is in the litigation timeline chart in this tab. Use this chart to see whether the law is protecting patients, shifting disputes, or creating administrative load, and why the recommendation preserves the shield while improving the back-end process.

CMS and Congressional Research Service, Federal IDR data · 2025 · source

Read it this way Team Health and Radiology Partners both win more often than the overall 88 percent average, while HaloMD wins less often than that average despite still winning most of its cases. The caveat notes two of the three figures are ranges plotted at their midpoint, so treat the bar heights as approximate. Use this chart to see whether the law is protecting patients, shifting disputes, or creating administrative load, and why the recommendation preserves the shield while improving the back-end process.

Caveat Two of the three are reported as ranges. Radiology Partners is 92 to 95 percent and HaloMD is 82 to 87 percent, plotted at their midpoints, with the ranges in the table.

Georgetown CHIR, No Surprises Act IDR process, early 2025 data · 2025 · source

Read it this way Every specialty's lowest-quarter award already clears the parity line, and the highest-quarter bars show how far awards can drift within a single specialty: neurology's highest quarter reached 17 times the benchmark against a low of 3 times. That within-specialty range is as important as the difference between specialties. Use this chart to see whether the law is protecting patients, shifting disputes, or creating administrative load, and why the recommendation preserves the shield while improving the back-end process.

CMS and Congressional Research Service, Federal IDR data · 2024 · source

Read it this way All four firms' median awards are several multiples of the insurer benchmark, led by HaloMD at more than eight times. Because these are firm-level medians from different 2025 quarters per the caveat, compare the relative ordering of firms rather than treating the percentages as simultaneous snapshots. Use this chart to see whether the law is protecting patients, shifting disputes, or creating administrative load, and why the recommendation preserves the shield while improving the back-end process.

Caveat Firm-level medians drawn from 2025 quarters. HaloMD and Radiology Partners are second-quarter figures. SCP Health and Team Health are period medians.

Georgetown CHIR, No Surprises Act IDR process, early 2025 data · 2025 · source

Read it this way The two court events shown mark when the insurer benchmark lost its special legal weight in arbitration. Read this timeline as the structural explanation for the rising provider-win and award-multiple trends charted elsewhere in this tab, not as a complete account of every factor involved. Use this chart to see whether the law is protecting patients, shifting disputes, or creating administrative load, and why the recommendation preserves the shield while improving the back-end process.

Georgetown CHIR and Federal IDR data · 2024 · source

Read it this way Just three initiators, named in the table as SCP Health, Team Health, and Radiology Partners, account for more than half of all dispute volume. This concentration matters because the win-rate chart elsewhere in this tab shows these same high-volume firms winning above the overall average. Use this chart to see whether the law is protecting patients, shifting disputes, or creating administrative load, and why the recommendation preserves the shield while improving the back-end process.

CMS, Federal IDR Supplemental Background Public Use Files · 2023 · source

Read it this way Six months of 2025 fees already exceed the entire three-year 2022-2024 total, showing the cost of running arbitration is accelerating rather than leveling off. This is the fee to operate the process itself and buys no medical care. Use this chart to see whether the law is protecting patients, shifting disputes, or creating administrative load, and why the recommendation preserves the shield while improving the back-end process.

Caveat The 2022-2024 total is $559M in IDR-entity fees plus $159M in administrative fees. The H1 2025 figure is an approximate.

CMS, Federal IDR data · 2025 · source