Claritev sees No Surprises Act IDR dispute initiations top 5.1 million through January 2026 - CTEV News | RalliesClaritev sees No Surprises Act IDR dispute initiations top 5.1 million through January 2026
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CTEV• No Surprises Act IDR dispute volume tops expectations
- Claritev’s 2026 No Surprises Act trend report flags IDR dispute volume far above expectations, raising payer administrative costs and payment inflation risk.
- CMS logged more than 5.1 million dispute initiations from April 2022 to January 2026, versus an original estimate near 35,000 per year.
- Disputes rose to 2.6 million in 2025 from 1.5 million in 2024; total IDR payouts exceeded $15 billion.
- Providers won about 83% of determinations in 2025 versus 12% for plans, reinforcing arbitration as a default payment-setting mechanism.
- Claritev analysis found 47.4% of 2025 submissions ineligible, pointing to eligibility screening as the biggest lever to cut volume.
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