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News
The federal government has certified its 17th arbiter under the No Surprises Act as out-of-network billing disputes hit record volumes. Physio Solutions (doing business as medlitix) joins the roster, though it isn't accepting cases yet. The surge in disputes — up 16% in just six months — has triggered backlogs, congressional scrutiny, and growing questions about arbiter fairness.
The No Surprises Act was designed to shield patients from unexpected out-of-network medical bills, but the arbitration system built to resolve payment disputes between providers and insurers is buckling under pressure. The federal government has certified Physio Solutions (d/b/a medlitix) as the 17th independent dispute resolution (IDR) entity — the fourth new arbiter added since June 2025 — in an effort to clear mounting backlogs.
The volume of disputes has far outpaced original projections. In the second half of 2025 alone, payers and providers submitted 1.4 million disputes — a 16% jump from the first half of the year. CMS says adding more certified entities like medlitix will improve efficiency and accountability, though the company is not yet accepting new cases.
By the Numbers:
Why it matters: The IDR system is a cornerstone of patient billing protections, but surging caseloads, potential arbiter bias flagged by Georgetown researchers, and payer complaints about ineligible disputes flooding the system raise serious questions about whether the process is working as Congress intended.
