'Some surgical assistants earn 25x more than surgeons: NYT'

 Some surgical assistants are earning 25 times what the surgeons make thanks to arbitration laws, The New York Times reported June 29.

Here is what to know.

1. Surgeons and surgical assistants have been capitalizing on the arbitration rule inside the No Surprise Act. Physicians win more than 85% of arbitrations and the significantly higher payouts. One physician earned $440,000 for a routine breast reduction, the Times found.

2. The 2020 law intended to protect patients from surprise billing by providers not in their insurance plan, and was meant to apply to  emergency and unscheduled care. However, many surgeons and assistants are taking scheduled cases to arbitration, wherein federal contractors review offers from each side and pick one as the fair price.

3. Typically, surgical assistants are paid a standard fee of 16% of the surgeon’s earnings. However, through arbitration some assistants are earning substantially more than the surgeon. In March, a Dallas surgical assistant earned $50,456 through arbitration for a prostate removal operation — meanwhile the surgeon on the case earned $1,843.

4. These surgical assistants are sometimes physicians, but more often they are nurses or physician assistants.

5. Patients are often unaware if their case was taken to arbitration, and pay what they normally would for an in-network provider. But the extra cost is passed onto patients as higher premiums. TeamCare, a health plan that covers half a million union workers, has spent $19 million on arbitration cases since 2022.

6. Physicians group argue that insurers often offer payments too low for physicians managing complex cases. Surgical assistant groups told the Times that health plans often refuse to let them into the networks, leaving them with unpredictable and low payments. 

https://www.beckershospitalreview.com/quality/hospital-physician-relationships/some-surgical-assistants-earn-25x-more-than-surgeons-nyt/