Rules, court decisions, and data on the No Surprises Act and the federal Independent Dispute Resolution process, with links to the original sources.
Sitting en banc, the Fifth Circuit held that insurers may not count “ghost rates” for services providers never perform, or automatically leave out bonus and incentive payments, when calculating the qualifying payment amount. The QPA is the benchmark insurers use for initial out-of-network payments.
Read more ↗
New rules require insurers to register in the federal IDR system, share more information with initial payments, and follow clearer timelines.
Read more ↗
A Georgetown University analysis of federal data finds that providers won 88% of disputes in the first half of 2025, the highest rate to date.
Read more ↗
The proposed rule set out changes to batching, eligibility review, and communication between insurers and providers. Most were finalized in 2026.
Read more ↗
A federal court in Texas sided with physicians, vacating a sharp increase in the IDR administrative fee and new limits on grouping claims.
Read more ↗
The Departments finalized rules on how arbiters weigh information in payment disputes and what insurers must disclose about the QPA.
Read more ↗
In its first months, the federal IDR process received far more payment disputes than regulators had expected.
Read more ↗Federal agencies report on the first months of the IDR portal, which opened April 15, 2022.
A federal court strikes down a rule that told arbiters to favor the insurer’s QPA over other factors.
Patients are protected from surprise bills, and payment disputes between providers and insurers move to the new federal process.
The second interim final rule sets out how open negotiation and arbitration will work.
The first interim final rule defines patient protections and how the QPA is calculated.
Passed as part of the Consolidated Appropriations Act, 2021, with bipartisan support.
Public data on dispute volume, outcomes, and timing from CMS.
Every No Surprises Act rule in one place.
CMS’s overview of the payment dispute process.
Summaries are written by United IDR Solutions. Linked articles belong to their publishers.