Reports, Experts Weigh 'No Surprises Act’ Arbitration Fixes

Fixes for the beleaguered arbitration process set up as part of the No Surprises Act (NSA) have begun to circulate in recent months as the health care sector grapples with a daunting backlog of unresolved Independent Dispute Resolution (IDR) cases. Policy experts say that modest tweaks should fix most problems, despite denouncements of IDR from providers and some members of Congress, and they point out that the NSA seems to have achieved its primary goal of protecting patients from exorbitant, unexpected bills for out-of-network emergency care. 

Still, there are problems with IDR in its current form, which is made clear by the large and growing backlog of undecided cases. According to a December report from the Government Accountability Office (GAO), parties submitted nearly 490,000 disputes between April 2022 and June 2023, closing only 38.6% of those cases. That means about 300,000 cases are still unresolved.