A STAT investigation into the business of the No Surprises Act found that the law, designed to shield patients from surprise medical bills, has also created a lucrative niche for arbitrators. The investigation, based on interviews with more than a dozen people and a review of over 100 pages of financial documents, focuses on iMPROve Health, a Michigan-based nonprofit that decides payment disputes between providers and insurers.
Before winning a government contract, iMPROve Health was struggling, losing over $2 million in 2022 alone and discussing a possible sale. Three years later, the organization reports a 70% profit margin—comparable to Nvidia's—and its revenue has grown 13-fold, according to the investigation.
The story highlights a broader pattern: while the No Surprises Act has succeeded in protecting patients from unexpected bills, it has also enriched a range of middlemen and health care providers. The investigation describes these arbitrators as operating like "mini gods" in high-stakes payment disputes, with little public oversight of their financial gains.