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ICYMI: New York Times Investigation Exposes How Out-of-Network Providers Are Exploiting the IDR Process to Extract Runaway Reimbursement
A new investigation from New York Times details how certain out-of-network providers have “flooded the arbitration system with millions of claims” under the No Surprises Act’s Independent Dispute Resolution (IDR) process—often “collecting fees hundreds of times higher...
A $440,000 Breast Reduction? How One Provider’s Playbook Exposes the IDR System’s Flaws
A new lawsuit filed by EmblemHealth lays out one of the most shocking accounts of how an out-of-network provider has allegedly contorted the No Surprises Act's Independent Dispute Resolution (IDR) into a personal ATM. The numbers are staggering. The complaint details...
ICYMI: New Health Affairs Data Shows IDR Costs and Volume Surging in First Half of 2025
A new analysis published in Health Affairs offers an early look at Q1-Q2 2025 data from the No Surprises Act’s federal Independent Dispute Resolution (IDR) process, finding that “the volume of cases submitted into the IDR process continues to exceed all expectations.”...
ICYMI: STAT News: “How a Texas couple is getting rich off out-of-network medical bills”
HaloMD has emerged as one of the leading companies abusing and misusing the No Surprises Act, and a new investigation from STAT News details how the company and its founders have developed a playbook for securing lucrative payouts from the arbitration process, also...
Flawed Incentives Driving Up Costs for Consumers & Employers
Abuse and misuse of the No Surprises Act’s independent dispute resolution (IDR) process is fueling the health care affordability crisis. One reason? The decision-makers at the center of the IDR process — known as IDR entities, or IDREs — benefit from misaligned...
ICYMI: Over 60 Organizations Call on Trump Administration to Fix Broken IDR Process
“Without meaningful oversight and accountability, the IDR process will continue to reward manipulation rather than fairness.” Over 60 employer, patient, and consumer organizations have called on the Trump administration to reform the No Surprises Act’s (NSA)...
Recent Report Details How Arbitration Could Become “Permanent Cost Escalator”
When Congress passed the No Surprises Act, the goal was clear: protect patients from unexpected out-of-network medical bills. The law has largely succeeded in that regard, shielding patients from most surprise bills — especially large balance bills tied to emergency...
Abuse & Misuse of Arbitration Fueling Affordability Crisis
The evidence of certain providers' routine abuse and misuse of the No Surprises Act’s Independent Dispute Resolution (IDR) process, also known as arbitration, has been overwhelming. Recent lawsuits reveal repeated and persistent patterns of fraudulent IDR submissions,...
Latest IDR Data Confirms Ongoing Abuse by Private Equity-Backed Providers and IDR Middlemen
The Centers for Medicare & Medicaid Services (CMS) just released new data from the first half of 2025 on the No Surprises Act’s Independent Dispute Resolution (IDR) process, and the numbers are staggering. Nearly 1.2 million disputes were filed in just six months,...
A +$2,000 Bill for a Runny Nose? Nutex Health’s Charges Show What Went Wrong With IDR
It’s no surprise that private equity-backed providers—including Nutex Health—have co-opted the No Surprises Act’s (NSA) IDR process into their go-to profit center. It’s the reason why private equity-backed championed arbitration as their “solution” to the surprise...