Dr. Norman Rowe advertises breast reduction surgery for $15,000 to $25,000. His practice now earns $440,000 for the same procedure by exploiting the No Surprises Act's arbitration system. The 2020 law was designed to protect patients from surprise medical bills, but doctors have flooded the system with millions of claims, winning 88% of cases.

Government officials expected about 17,000 arbitration cases annually. Instead, doctors filed 1.2 million cases in the first half of last year. Arbitrators earned $885 million from 2022 to 2024. Some health plans have raised premiums to cover the costs—the United Service Workers health plan increased premiums by 1.75 percentage points.

EmblemHealth sued Dr. Rowe in March, alleging his use of arbitration amounts to fraud. Representative Frank Pallone Jr., who helped negotiate the law, said Congress needs to rein in the arbitration process. The system has enriched a new industry of billing specialists while some physicians say they are salaried and uninvolved in claims filed under their names.