Payer CEOs Sharpen Attacks on No Surprises Arbitration

Health insurance executives are turning up the volume against the No Surprises Act's arbitration system, known as independent dispute resolution, or IDR. On Cigna's second-quarter earnings call July 30, President and CEO Brian Evanko said the company backs the law's goal of shielding consumers from surprise medical bills but sees the arbitration mechanism being misused in practice, according to Becker's Hospital Review.

"We're seeing some clear abuses of the IDR vehicle in practice," Evanko said. His comments add to a growing chorus of payer leaders framing IDR as a driver of higher out-of-network payouts rather than a narrow backstop for genuine billing disputes.

The 2020 law created IDR so insurers and providers could settle out-of-network payment fights through a neutral arbiter, keeping patients out of the middle. But case volume has vastly exceeded federal projections, and providers, backed by favorable court rulings, have won a large share of disputes. The escalating rhetoric signals payers will keep pressing regulators and courts to tighten how the process works.