ASA Leads Fight Against Payer Efforts to Turn NSA IDR Participation into Legal Risk

The American Society of Anesthesiologists (ASA) filed an amicus brief to address a significant threat to anesthesiology practices arising from the case between UnitedHealthcare and NorthStar Anesthesia. In this case, United seeks to treat routine eligibility mistakes in the No Surprises Act’s independent dispute resolution (IDR) process as fraud—an approach that could have a chilling effect on physicians’ willingness to use the process at all. ASA warned that if ordinary, good-faith errors are recast as fraud, anesthesiology practices could face widespread litigation risk simply for participating in IDR, undermining their ability to secure fair payment. Drawing on the experience of its members, ASA emphasized that eligibility determinations are inherently complex, often requiring providers to navigate incomplete information, technical rules, and varied insurance arrangements—reflected in the fact that nearly one in four IDR disputes has been deemed ineligible.

ASA’s brief makes clear that these eligibility mistakes are not fraud, but rather a predictable consequence of a complicated system that providers must navigate while delivering patient care. Anesthesiologists, in particular, often lack direct access to full insurance details and must rely on information provided by others, increasing the likelihood of good-faith errors. ASA highlighted that both federal regulators and healthcare stakeholders recognize these challenges and are actively working to improve transparency—especially by requiring insurers to provide clearer, more complete information to physicians so they can make accurate eligibility determinations.

Importantly, ASA continues to lead in advocating for a fair and functional IDR system that ensures anesthesiologists are appropriately paid for the care they provide. The organization emphasized that Congress created a robust administrative framework—administered by federal agencies—to resolve disputes and correct eligibility errors, and that this system, not litigation, is the proper avenue for addressing disagreements. By advancing policy solutions, submitting regulatory comments, and educating courts on the realities of clinical practice and billing, ASA is working to preserve the integrity of the IDR process and protect anesthesiologists’ practices.