No Surprises Act

Coverage of No Surprises Act developments, Independent Dispute Resolution (IDR) rules, and their impact on provider reimbursement.

Federal IDR Process Faces New Scrutiny Over Planned Procedure Payments
No Surprises Act

July 15, 2026

Federal IDR Process Faces New Scrutiny Over Planned Procedure Payments

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%…

Read Article
Federal IDR Fee Drops from $115 to $15: What Healthcare Providers Need to Know
No Surprises Act

June 3, 2026

Federal IDR Fee Drops from $115 to $15: What Healthcare Providers Need to Know

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.

Read Article
New Federal Rule Slashes Arbitration Costs by 85% for Anesthesia Groups Challenging Insurance Underpayments
No Surprises Act

June 1, 2026

New Federal Rule Slashes Arbitration Costs by 85% for Anesthesia Groups Challenging Insurance Underpayments

Industry experts say changes could save specialty practices thousands of dollars while speeding resolution of out-of-network payment disputes

Read Article
Client Alert: Proposed IDR Rule Changes
No Surprises Act

April 1, 2026

Client Alert: Proposed IDR Rule Changes

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.

Read Article
NorthStar Anesthesia Providers Sue Aetna and Cigna Over $4.1M in Alleged IDR Underpayments
No Surprises Act

January 5, 2026

NorthStar Anesthesia Providers Sue Aetna and Cigna Over $4.1M in Alleged IDR Underpayments

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.

Read Article
UnitedHealthcare Sues Nation’s Largest Radiology Group Over No Surprises Act Disputes
No Surprises Act

September 8, 2025

UnitedHealthcare Sues Nation’s Largest Radiology Group Over No Surprises Act Disputes

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.

Read Article
Elevance Lawsuits Signal Growing Scrutiny of IDR Under No Surprises Act
No Surprises Act

June 17, 2025

Elevance Lawsuits Signal Growing Scrutiny of IDR Under No Surprises Act

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.

Read Article
Now Is the Time to Leverage IDR: A Smart Path Forward Under the No Surprises Act
No Surprises Act

June 16, 2025

Now Is the Time to Leverage IDR: A Smart Path Forward Under the No Surprises Act

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.

Read Article
No Surprises Act Lawsuit Filed by AMA and AHA
No Surprises Act

June 29, 2023

No Surprises Act Lawsuit Filed by AMA and AHA

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.

Read Article

Stay Ahead of Healthcare Law Changes

Patriot Group monitors regulatory developments and payer tactics so your practice doesn't have to operate blind. Speak with our team today.