Over the past two years, Flight for Life has airlifted car crash victims, premature babies and adults struggling to breathe to hospitals across southeastern Wisconsin. Anthem, the major health insurer, covered dozens of those patients, but it has refused to pay $2.1 million it owes the company for their helicopter rides. The amounts due for each emergency medical flight range from $9,382 to $62,373. Anthem has historically paid its bills, but late last year it suddenly stopped. "It was like a faucet they just shut off," said Flight for Life's executive director, Leif Erickson.
The insurer's willful nonpayment is the latest in a cascade of unintended consequences brought about by the No Surprises Act, a widely supported law that took effect in 2022 to protect patients from surprise medical bills. The law calls for arbitrators to decide appropriate levels of reimbursement, and it has already triggered millions of disputes between medical care providers and insurers. Doctors have prevailed overwhelmingly, winning arbitration settlements that sometimes far exceeded the usual insurer rates. Now, fed up with what they consider unfair outcomes, insurers are fighting back by refusing to pay.
Lawmakers expected the arbitration system to be used rarely and to produce reasonable payments. Instead, providers have swamped arbitrators with claims, often for amounts far above what is customarily paid for a service. Insurers have sued doctors and lobbied Congress to change the law, contending that large awards are driving up premiums. With Washington moving slowly, they have simply declined to pay. Nearly 30 percent of arbitration awards have gone unpaid since 2024, according to an analysis of 400,000 awards by Halo MD. Anthem's nonpayment rate was the highest, at 74 percent, while Cigna, United Healthcare and Aetna have also declined to pay a significant portion.
Katie Keith, director of Georgetown University's Center for Health Policy and the Law, said both sides are behaving badly. "The providers are succeeding in what feel like egregious award levels, and then the insurers are also doing some of this egregious behavior by not paying," she said. "But there's not accountability on either side."
Health plans have criticized Halo MD for business tactics they say exploit the arbitration system. A Cigna spokeswoman said a significantly smaller share went unpaid in 2026 than the Halo data showed. Most large insurers say it is their policy not to pay awards if they believe a claim should never have qualified for arbitration, even when an arbitrator found it eligible.
Source: New York Times Top Stories · Summarized by HeadlinesBriefing