CMS Reports Highlight Surge in No Surprises Act Disputes, Raising Concerns Over Healthcare Costs
The Centers for Medicare & Medicaid Services (CMS) has released new data indicating a significant increase in disputes under the No Surprises Act, with nearly 1.4 million disputes initiated in the latter half of 2025. This marks a rise from the 1.2 million disputes in the first half of the year. The independent dispute resolution (IDR) process, which is central to these disputes, has been criticized by insurers for leading to ballooning payments to providers. In 2025, providers received approximately $15 billion in IDR payouts, a substantial increase from the $4.1 billion in 2024. The data also reveals that payments determined through IDR are often higher than the qualifying payment amounts proposed by insurers. A small number of organizations, such as HaloMD and TeamHealth, account for a large portion of these disputes. Insurers have expressed concerns over what they describe as provider-driven abuse of the No Surprises Act, calling for regulatory action to address the issue.