Investigative Report on Egregious Medical Billing Practices Misses the Mark

The New York Times deserves credit for publishing a recent investigative report spotlighting rampant medical overbilling (“Insurers Reap Hidden Fees by Slashing Payments. You May Get the Bill”). But there’s more to the story that needs to be told. Much of the focus was on a private-equity-backed firm called MultiPlan, whose work was depicted as … Continued

Independent Dispute Resolution Data Shows Need for Transparent Pricing Assistance

Intensifying federal government oversight on the issue of healthcare price transparency and involvement in the resolution of provider and insurer payment disputes suggests a growing need to arm group health plan sponsors and participants with the information they need to navigate the No Surprises Act Independent Dispute Resolution (IDR) process. While enforcement of the evolving … Continued

Yes, No or Maybe: Will New Rules Lower Your Medical Costs

Click here to access our latest article published in Employee Benefit Plan Review, a leading resource for benefit decision-makers, providing industry news, market trends and peer-inspired insights about improving outcomes, enhancing the patient experience and lowering the cost of care. Author Jack Towarnicky, member of aequum, was appointed in 2023 to a three year term … Continued

The No Surprises Act: Litigation Continues

The No Surprises Act (the “NSA”) has generated (and will continue to generate) a significant amount of litigation. The Plaintiffs, who are primarily medical provider organizations, used the practice of forum shopping to bring their cases in the court that will treat them most favorably. For the rule-making cases, the most favorable is the United … Continued

What Employers Can Do to Help Stem Rising Medical Debt

A growing movement is afoot to help Americans erase medical debt. It’s part of a cultural tipping point that acknowledges the financial fragility of both working and middle-class households. Many who secure treatment are unable to pay their out-of-pocket expenses – households living paycheck to paycheck before their illness or injury, and those whose illness … Continued

No Surprises Act Arbitration Update

The No Surprises Act IDR process has had many starts and stops this year, creating even a greater backlog of cases. Needless to say, it has not been a smooth roll out. During the period between April 15, 2022 and June 30, 2023, 490,000 disputes were initiated — more than 22 times the amount of … Continued