Sep 11, 2026 · 7 min · 7 segments
A prominent House Democrat is probing the behavior of No Surprises Act arbiters. A federal audit finds Medicare Part D plans spent hundreds of millions of dollars on ineligible drugs. And smart ring…
[outro music] A top House Democrat is investigating how third-party arbiters decide payment disputes under the No Surprises Act.
The law, enacted in 2020 and implemented in 2022, protects patients from certain surprise out-of-network medical bills.
It establishes a negotiation process for providers and insurers to resolve payment disagreements, with the federal independent dispute resolution, or IDR process, available when those negotiations fail.
Federal officials originally estimated around 17,000 disputes annually, but about 2.5 million disputes were filed in 2025, with another 1.4 million filed in the first five months of this year, according to estimates.
New Jersey Democrat Frank Pallone, the ranking member of the House Energy and Commerce Committee, sent oversight letters to six IDR entities on September 3rd, after they did not respond to earlier informal requests for information.
Pallone, who helped pass the law, cited rising dispute volumes and concerns about consumer costs.
He said he was concerned, quote, "That the independent dispute resolution process is not functioning as Congress intended and is resulting in increased out-of-pocket costs and higher premiums for consumers." End quote.
His office also cited reports that providers won more than eighty-five percent of payment determinations in 2025, with awards totaling nearly fifteen billion dollars, more than six times estimated local in-network rates.
The letters requested information on dispute eligibility, default judgments, staff qualifications and compensation, potential use of automated or AI tools in decision-making, and potential financial ties to parties involved in disputes.
Pallone also wants details on internal quality reviews and consistency among arbiters.
[outro music] A top House Democrat is investigating how third-party arbiters decide payment disputes under the No Surprises Act.
The law, enacted in 2020 and implemented in 2022, protects patients from certain surprise out-of-network medical bills.
It establishes a negotiation process for providers and insurers to resolve payment disagreements, with the federal independent dispute resolution, or IDR process, available when those negotiations fail.
Federal officials originally estimated around 17,000 disputes annually, but about 2.5 million disputes were filed in 2025, with another 1.4 million filed in the first five months of this year, according to estimates.
New Jersey Democrat Frank Pallone, the ranking member of the House Energy and Commerce Committee, sent oversight letters to six IDR entities on September 3rd, after they did not respond to earlier informal requests for information.
Pallone, who helped pass the law, cited rising dispute volumes and concerns about consumer costs.
He said he was concerned, quote, "That the independent dispute resolution process is not functioning as Congress intended and is resulting in increased out-of-pocket costs and higher premiums for consumers." End quote.
His office also cited reports that providers won more than eighty-five percent of payment determinations in 2025, with awards totaling nearly fifteen billion dollars, more than six times estimated local in-network rates.
The letters requested information on dispute eligibility, default judgments, staff qualifications and compensation, potential use of automated or AI tools in decision-making, and potential financial ties to parties involved in disputes.
Pallone also wants details on internal quality reviews and consistency among arbiters.
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