By Chris Myers
Welcome to "Healthcare Uncovered: No Surprise Bill's Weekly Report" with Chris Myers—the weekly newsletter where I break down the latest news impacting patients, providers, and insurers. I’m glad you’re here.
Our team just attended the 2025 EDPMA Solutions Summit. It was more than just another conference—it was a crucial gathering of emergency medicine leaders tackling the biggest challenges in our field. Held at in Colorado Springs, the event brought together policymakers, physicians, and industry experts to discuss everything from surprise billing to the financial sustainability of the Independent Dispute Resolution (IDR) process.
As always, the conversations were lively, and the takeaways were significant. Here are some of the key insights I walked away with:
30 Million Americans Have Avoided Surprise Bills
One of the most notable successes of the No Surprises Act (NSA) is the number of patients protected from unexpected medical bills—30 million and counting. While the law has faced its share of challenges, this milestone is a reminder that progress is being made.
The Dispute Resolution Process Still Faces Hurdles
We learned that 45% of disputes in the first half of 2024 were challenged by payors after determining patient eligibility. This raises concerns about how disputes are being handled and whether insurers are leveraging eligibility as a delay tactic. The IDR process was designed to be fair and efficient, but these numbers suggest that there’s still work to do in ensuring it functions as intended.
Ground Ambulance Billing Remains Unresolved
Ground ambulance billing continues to be a major gap in the NSA’s protections. The Advisory Committee on Ground Ambulance and Patient Billing (GAPB) initially recommended against using the IDR process when it was still in its infancy, but that was before the system had matured. Given how much more efficient the IDR process has become, perhaps it’s time to revisit that decision and find a viable path forward for ambulance services.
The IDR Program is Financially Sustainable
A key point of discussion was the financial health of the IDR program. The data shows that the program is paying for itself—expected costs for 2024 are $49 million, while fees collected are projected to reach $80 million. There’s a $14 million surplus, proving that the system can be both effective and self-sustaining.
Final Thoughts
The discussions at the EDPMA Summit reinforced that while we’ve made significant strides in emergency medicine policy, there are still critical issues to address. The challenge now is ensuring that the IDR process works as fairly and efficiently as possible while continuing to push for solutions in areas like ground ambulance billing.
The conversations we had at The Broadmoor won’t stay in the conference halls—they’ll fuel the work ahead as we advocate for better policies and stronger protections for patients and providers alike.
