Coverage of No Surprises Act developments, Independent Dispute Resolution (IDR) rules, and their impact on provider reimbursement.
August 19, 2026
The Fifth Circuit struck down key federal rules for calculating the Qualifying Payment Amount, potentially affecting provider reimbursement and IDR strategy.
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August 17, 2026
Healthcare providers are claiming a major victory after a federal appeals court ruled that health insurers cannot manipulate reimbursement calculations.
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July 15, 2026
New research from the Elevance Health Public Policy Institute examines how the federal Independent Dispute Resolution (IDR) process is affecting reimbursement for certain planned procedures. The study found providers prevailed in nearly 90%…
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June 3, 2026
Healthcare providers utilizing the federal Independent Dispute Resolution (IDR) process under the No Surprises Act will soon see significant changes aimed at improving efficiency and reducing administrative burdens. On May 28, 2026, the Departments of Health and Human Services, Labor, and Treasury, along with CMS, finalized new rules that overhaul key aspects of the federal IDR process.
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June 1, 2026
Industry experts say changes could save specialty practices thousands of dollars while speeding resolution of out-of-network payment disputes
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April 1, 2026
Federal agencies are advancing updates to the Independent Dispute Resolution process. The Proposed Federal IDR Operations Rule is under review by the Office of Management and Budget, signaling that final regulations may be issued soon.
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January 5, 2026
In a lawsuit filed on December 8, 2025, in the U.S. District Court of Connecticut, a group of 33 NorthStar anesthesia providers alleged that Aetna and Cigna failed to comply with binding IDR decisions under the No Surprises Act. The complaint asserts that the two insurers owe more than $4.1 million in total — approximately $2.3 million from Cigna and $1.7 million from Aetna — for services already adjudicated through the federal arbitration process.
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September 8, 2025
UnitedHealthcare, the largest health insurer in the country, filed a lawsuit in August 2025 against Radiology Partners, the nation’s largest radiology group, accusing the provider of manipulating the Independent Dispute Resolution (IDR) process under the No Surprises Act. The suit, filed in federal court in Arizona, claims Radiology Partners used a separate out-of-network entity—Sonoran Radiology—to submit claims for services actually performed by in-network physicians, allegedly to generate higher reimbursements through arbitration.
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June 17, 2025
Two new lawsuits from Elevance Health subsidiaries are raising significant questions about how providers are using the No Surprises Act’s Independent Dispute Resolution (IDR) process. The cases, filed by Anthem Blue Cross and Blue Shield of Ohio and Blue Cross Blue Shield Healthcare Plan of Georgia, accuse healthcare providers and billing company HaloMD of submitting large volumes of ineligible claims through IDR to boost reimbursements and drive up arbitration costs.
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June 16, 2025
A recent letter from the ERISA Industry Committee (ERIC) urges the IRS to revise the No Surprises Act’s (NSA) dispute resolution framework, claiming it places too much financial pressure on employer-sponsored health plans. According to ERIC, out-of-network providers are winning the majority of arbitration cases and receiving payments significantly higher than in-network rates.
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June 29, 2023
Adding to the chaos underlying the implementation of the No Surprises Act (the “NSA”), on Thursday, December 9, 2021, the American Medical Association and the American Hospital Association, among others, filed suit in the U.S. District Court for the District of Columbia against the U.S. Depts. of Health and Human Services, of Labor, and of the Treasury, as well as the Office of Personnel Management (collectively, the “Departments”), requesting that the Court issue an injunction against certain aspects of the Interim Final Rule issued on September 30, 2021 (the “IFR”). See Case No. 1:21-cv-03231.
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