Our mission

Full and faithful implementation and enforcement of the No Surprises Act, for patients and the practices they rely on.

The Medical Practice Support Alliance (MPSA) advocates to protect patients from surprise medical bills, defend medical providers from insurance abuse, and advocate for patient access to robust in-network care with fair reimbursement.

Protect patients

Keep patients out of the middle of billing disputes by shielding them from the surprise bills the NSA effectively prevents.

Defend providers

Stand with clinicians and medical groups against insurer abuse, underpayment, delay, denial, and forced contract termination.

Preserve access

Advocate for robust in-network care with fair reimbursement, so practices stay viable and communities keep access.

Why action can't wait

The evidence is in: insurer abuse harms patients and providers.

National survey data document a consistent pattern: costs shifted to patients, payments cut and delayed, and the law's Independent Dispute Resolution (IDR) safeguards undermined.

The journey of one claim

A claim is filed

The provider submits a claim — and the very first payment offer already arrives systematically underpriced.

93%

of providers received Qualifying Payment Amounts at or below antiquated Medicare rates.

Open Negotiations are ignored

The No Surprises Act guarantees a negotiation window to resolve the gap. Insurers stonewall it.

50%

of the time, insurers are not replying to Open Negotiations requests.

30%

of the time, insurers are not disclosing which claims were IDR-eligible.

Only 1%

of disputes, on average, are being resolved during Open Negotiations.

Months of delay set in

With negotiation exhausted, providers are left waiting — and waiting — simply to be paid.

194days

average delay before payment after a claim is filed.

Payments are cut — or never come

Even after a provider wins through Independent Dispute Resolution, reimbursement is cut short or withheld altogether.

50%

of payments after IDR are not being made within the required 30 days.

11%

of IDR awards are not being paid by insurers at all (zero payments).

32%

how much payments are being cut after insurers terminated in-network contracts.

The same playbook affects patients, too

These tactics don't stop at payment. They reshape who patients can see and what care costs them.

Shredding access to in-network care

1 in 5

providers are experiencing insurer-driven contract termination.

19%

are receiving ‘take-it-or-leave-it’ unilateral contract amendments that slash reimbursement.

Other abuse plaguing patients

87%

reported insurers are increasing patient cost sharing — 7,258 times in 2024 — fueling medical bad debt.

86%

reported insurers are denying payment for NSA-related covered services — 42,404 times in 2024.

Source: Americans for Fair Health Care, No Surprises Act Impact Analysis (2025). Figures reflect 2024 data collected from clinicians across 45 states.

Our promise

The NSA is a success by taking patients out of the middle of billing disputes.

MPSA exists to make sure it stays that way.

Help us hold the line.

Join the firms and companies standing up for fair reimbursement and patient access to care.

Join the Alliance → Myths vs. facts