November 13, 2025
On Oct. 24, AHIP and the Blue Cross Blue Shield Association (BCBSA) released findings from their 2024 No Surprises Act (NSA) survey, which revealed that nearly 40% of surprise billing disputes submitted to the federal Independent Dispute Resolution (IDR) process in 2024 were ineligible under the NSA. More than half of these ineligible disputes still advanced through arbitration, ultimately forcing employers and health plans to pay unnecessary and exorbitant claims. Of the nearly 20 million qualified IDR claimsacross all provider types in 2024, emergency services accounted for the majority (61%). Three out of four (76%) claims were paid without further dispute when providers accepted the plan’s initial payment. Recent data from Georgetown University’s Center on Health Insurance Reforms estimates that the systemic flaws with arbitration and rampant misuse of the process have led to $5 billion in wasteful spending to date.
AHIP and BCBSA will use the results of their survey to continue to urge policymakers to reform the IDR system to curb abuse and ensure it functions as a fair backstop, not a loophole.
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