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Solving surprise medical bills was supposed to be straightforward. It has been anything but.

Already, eight different providers — all physicians, air ambulances, or hospitals — have sued the government over its first efforts to lay out the specifics of Congress’ 2020 law that protects patients from getting ambushed by many types of medical bills. And now, providers and health insurers are ramping up their finger-pointing, each accusing the other of gumming up the law’s new arbitration process and acting in bad faith.

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All eyes are now on the federal government, which is finishing new rules that will determine exactly how those out-of-network disputes get settled — rules that will also portend whether the law will continue to get dragged through litigation. Lobbyists and patient advocates are working overtime to ensure they come out ahead.

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