Claritev sees No Surprises Act IDR dispute initiations top 5.1 million through January 2026

PUBT · 1d ago
Claritev sees No Surprises Act IDR dispute initiations top 5.1 million through January 2026
  • 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.


Disclaimer: This news brief was created by Public Technologies (PUBT) using generative artificial intelligence. While PUBT strives to provide accurate and timely information, this AI-generated content is for informational purposes only and should not be interpreted as financial, investment, or legal advice. Claritev Corporation published the original content used to generate this news brief on July 29, 2026, and is solely responsible for the information contained therein.