Independent Dispute Resolution process

Health care providers won the vast majority of the fee disputes adjudicated through the No Surprises Act’s Independent Dispute Resolution process during the first half of 2025. The volume of those disputes submitted to arbitration rose nearly 40 percent over the first half of 2024, to 1.2 million cases, and the victory rate of providers also rose, from 85 percent to 88 percent.Leading the way for providers were private equity-backed parties, with three such companies accounting for 44 percent of the disputes submitted during the first half of 2025 and ten of those companies filing nearly 70 percent of all [...]

When a federal court in Texas rejected an increase in the fee for providers to initiate payment challenges under the No Surprises Act’s Independent Dispute Resolution process, the Centers for Medicare & Medicaid Services quickly suspended use of that process while it reviewed the court ruling – suspended both the adjudication of current complaints and the filing of new ones. Almost as quickly, CMS announced that it would reduce the fee required to initiate payment disputes between providers and payers under the 2020 law that sought to prevent surprise medical bills from $350 to $50 – but it did not [...]