Skip to main content

No Surprises Act Disputes Continue to Rise, Providers Blame Insurers

Analysis  |  By Jasmyne Ray  
   February 22, 2024

Over 288,000 disputes were submitted through the portal during the first six months of 2023.

Organizations have been struggling to abide by the No Surprises Act since it went into effect in 2022. Now, two years later, the number of surprise billing disputes is climbing higher and higher each quarter, according to data from the Centers for Medicare & Medicaid Services.

From January to June 2023, over 288,000 disputes were submitted through the federal independent dispute resolution, IDR, portal. The IDR has struggled to keep up with the substantial number of submissions since the portal was opened in 2022.

According to CMS, the majority of these disputes were initiated by a small number of providers, who have been vocal in their belief of insurers taking advantage of the law.

A previous HealthLeaders story examined the results of a survey of over 48,000 physicians, investigating how insurers use the law. Regarding payments for independent dispute resolutions in favor of providers, 52% of respondents said payments were never made, 49% said payments weren’t made within the 30-day period, and 33% said were paid an incorrect amount.

Staying on top of price transparency efforts and compliance is one-way providers and health systems to get ahead of payers and potential disputes.

“Reach out to peers to brainstorm on ways they have accomplished compliance, so you don’t need to reinvent the wheel,” Tina Barsallo, vice president of revenue cycle operations at Lifepoint Health, previously told HealthLeaders.

Jasmyne Ray is the revenue cycle editor at HealthLeaders. 

Get the latest on healthcare leadership in your inbox.