Providers, facilities and air ambulances won 88% of disputes in the first half of 2025.
In January, CMS released independent dispute resolution data from the first and second quarters of 2025, including details on disputing parties and payment determinations.
The No Surprises Act’s independent dispute resolution process aims to mediate out-of-network payment conflicts, but the system has been a source of controversy. Research points to at least $5 billion in spending on the process since 2022.
Here are four other things to know:
1. Providers initiated the majority of disputes, followed by facilities and then health plans or issuers. Health plans spearheaded 131 of the 1.19 million disputes, whereas providers prompted 957,960, or 81%.
2. Four groups initiated the most disputes: HaloMD, Team Health, SCP Health and Radiology Partners.
3. Texas was the frontrunner with 456,162 dispute initiations, followed by Arizona, Florida, New Jersey and New York.
4. Of all the payment determinations, nearly 88% of offers exceeded the qualifying payment amount.
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