Washington – The ERISA Industry Committee (ERIC) joined America’s Health Insurance Plans (AHIP) and coalition allies in filing an amicus brief with the U.S. Court of Appeals for the Second Circuit in Agag v. Cigna Health and Life Insurance Company. The brief argues that a district court ruling letting providers sue health plans in federal court over unpaid arbitration awards ignores the administrative process Congress built under the No Surprises Act (NSA) to resolve these disputes.
ERIC’s brief points out that opening the courts to these disputes would let the same billing firms already flooding the Independent Dispute Resolution (IDR) process with ineligible claims flood the courts too, driving up costs that employers and workers ultimately pay through higher premiums.
“Congress created an administrative process to resolve these payment disputes quickly and cheaply, not a new pipeline into federal court. Handing that job to litigation instead invites more of the abuse we’re already seeing,” said Doug Hinson, Executive Director of the ERIC Legal Center. “A small number of billing firms are already flooding the arbitration system with claims that are clearly not eligible for the process under the No Surprises Act. Opening the courthouse doors on top of that just hands them a second venue to run up costs.”
Congress designed the NSA’s arbitration process, called IDR, to be rarely used and keep billing disputes between health plans and providers out of court. Instead, providers and the billing firms that represent them filed more than 2.5 million disputes in 2025, about 115 times what regulators anticipated, turning IDR into a profit center for a small number of high-volume filers rather than the narrow backstop Congress intended.
Nearly 40 percent of those disputes were not even eligible for arbitration, and payouts reached almost $15 billion last year, more than triple 2024’s total. The brief argues that letting providers sue in court to enforce improper awards would only invite more abuse. In addition to the overwhelming number of IDR claims, these third parties would flood the courts with payment disputes, driving up costs and making the problem worse.
Read the brief here.