Bipartisan legislation recently introduced in Congress aims to strengthen enforcement of the No Surprises Act (NSA) by holding health plans accountable when they fail to pay physicians in accordance with final Independent Dispute Resolution (IDR) decisions.

The bill (H.R. 4710/S. 2420), introduced by Sens. Roger Marshall, M.D. (R-KS) and Michael Bennet (D-CO), along with Reps. Greg Murphy, M.D. (R-NC), Kim Schrier, M.D. (D-WA), John Joyce, M.D. (R-PA), Jimmy Panetta (D-CA), Bob Onder, M.D. (R-MO), and Raul Ruiz, M.D. (D-CA), would increase penalties on plans that fail to comply with the payment timelines required under federal law.

The NSA, enacted in 2020, protects patients from surprise medical bills and created an IDR arbitration process to fairly resolve out-of-network billing disputes between insurers and physicians. But despite the law’s intent, many health plans have failed to comply with final IDR decisions. A 2024 survey by the Emergency Department Practice Management Association found that 24% of emergency physicians reported IDR awards that were either unpaid or incorrectly paid beyond the 30-business-day deadline required by the NSA.

CMA has been a vocal advocate for proper implementation of the NSA, ensuring the dispute resolution process remains balanced and consistent with congressional intent. CMA also joined several successful legal challenges—led by the Texas Medical Association—against flawed federal rules that tilted the process in favor of insurers.

This new legislation marks a critical step toward meaningful enforcement of the NSA and reinforces the need to hold health plans accountable when they fail to follow the law.