Washington – The ERISA Industry Committee (ERIC) and coalition allies filed an amicus brief with the U.S. Court of Appeals for the Fifth Circuit supporting Blue Cross Blue Shield of Texas (BCBSTX) in Blue Cross Blue Shield of Texas v. HaloMD, LLC. The brief asks the court to reverse a ruling that dismissed BCBSTX’s lawsuit before it could be heard.
BCBSTX alleges that HaloMD, a company that mass files billing disputes for out-of-network providers, obtained thousands of awards through the No Surprises Act’s (NSA) independent dispute resolution (IDR) process by falsely certifying that the disputes were eligible. The district court held that federal and Texas law bar courts from hearing the claims. If that ruling stands, employers and their health plans would have nowhere to challenge deliberate misuse of the system.
“Congress designed the IDR process to be a last resort, but some middleman entities have turned it into a volume business,” said Doug Hinson, Executive Director of the ERIC Legal Center. “Every award obtained through a false eligibility claim gets paid by employers and their workers, through higher premiums and thinner coverage. When a plan has evidence that the process was gamed, it should be able to bring that evidence to a judge.”
Federal agencies projected about 22,000 IDR disputes a year. In 2025, roughly 2.6 million were filed. HaloMD alone accounted for 27 percent of resolved dispute lines. The median award in HaloMD disputes was more than nine times the plan’s median in-network rate. Although the IDR process was projected to lower healthcare costs, researchers estimate the process has pushed the NSA’s total costs past $22.4 billion in four years. The lawsuit claims that intentionally filing thousands of claims ineligible for the process significantly contributes to those costs.
The brief explains that plans have little protection inside the process. They get three business days to object that a dispute doesn’t qualify, and the arbitrator reviewing the objection is paid nothing if it agrees. In the second half of 2025, plans challenged 42 percent of disputes as ineligible, while arbitrators dismissed only 19 percent.
Read the full brief here.