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flag Insurers began charging hospitals fees for out-of-network referrals in Jan. 2026 to cut No Surprises Act disputes, sparking criticism over patient costs and hospital strain.

flag Insurance companies, including Elevance Health, began charging hospitals administrative fees in January 2026 for referring patients to out-of-network providers, a move aimed at reducing disputes under the No Surprises Act. flag The fees come after a surge in independent dispute resolution cases—nearly 2 million in 2025, far exceeding the projected 18,000—leading insurers to claim they lost about 80% of negotiations. flag Critics, including Indiana Senator Scott Baldwin, argue the fees shift costs to patients, harm hospital finances, and may force hospitals to avoid independent doctors, reducing competition. flag A bill to ban the fees was discussed in committee but did not advance.

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