“Get your check book ready………………” – Don Pedro
Eliott Listman – Allia Group – Litigation CEO
A federal court in Connecticut ruled that providers can sue to enforce unpaid IDR awards under the No Surprises Act, rejecting insurer arguments that there’s no private right of action.
Here’s what it means:
1. If an IDR award is issued, insurers don’t get to stall or ignore it.
2. “Shall pay” means shall pay (not “when convenient.”)
3. Systemic underpayments can also trigger liability under ERISA and even state-level consumer protection laws.
While courts across the country remain split, the direction is clear: the legal risk for insurers who refuse to honor IDR outcomes is growing, and fast.
At Allia Group, we’ve said it from the start: insurers have treated IDR as just another delay tactic. Every ruling like this moves the system closer to what the law was supposed to be — a binding process that payers can’t sidestep.
