Turn on cookies to sign in
Signing in saves your progress to your Curie account. We can only do that with cookies on — turn them on to continue.
The Trump administration has removed two arbiters from the No Surprises Act's billing dispute process, citing failure to meet performance standards. Island Peer Review Organization and Network Medical Review Company — which together handled hundreds of thousands of cases — lost their certifications as critics accused them of systematically favoring providers. Insurers cheered the move, while both firms said they're weighing appeals.
The Trump administration has decertified two arbiters from the No Surprises Act's independent dispute resolution (IDR) process — Island Peer Review Organization (IPRO) and Network Medical Review Company (NMRC) — citing failure to meet performance standards around timeliness, accuracy, and impartiality. The move comes amid growing scrutiny of a system designed to protect patients from surprise out-of-network bills, but which has become a major flashpoint between insurers and providers.
Critics have long argued that arbiters are financially incentivized to favor providers: they're paid per dispute (between $425–$800 each) and receive nothing if a case is deemed ineligible — creating pressure to rule in providers' favor to keep the filings coming. IPRO had one of the highest provider win rates in the system at nearly 97%, and awards have sometimes reached striking levels, including a $440,000 payout for a breast reduction that typically costs around $20,000.
By the Numbers:
Why it matters: The decertifications signal a potential turning point in how the federal government oversees surprise billing arbitration. With eight more arbiters currently under review and lawmakers exploring an overhaul of the process, the IDR system's future — and its broader impact on healthcare costs — remains very much in flux.
