Earlier this week, the Trump administration denied recertification requests from Island Peer Review Organization and Network Medical Review Company. Insurers cheered the decision.

The Trump administration has booted two arbiters from the federal process used to resolve disputes between doctors and insurers over out-of-network bills, a move critics of the law applauded as a long-needed crackdown on allegedly biased referees.

The CMS disclosed on Wednesday that it had denied applications from Island Peer Review Organization and Network Medical Review Company to be recertified. Both organizations have served as arbiters in the independent dispute resolution, or IDR, process for the past five years, settling hundreds of thousands of billing disputes between health plans and doctors.

IDR was created by the No Surprises Act, a law passed in 2020 to protect patients from being hit with a surprise medical bill when they unknowingly received care from an out-of-network provider. In IDR, insurers and providers both submit what they believe to be a fair reimbursement amount to an arbiter, which then picks one of the two offers.

The process was meant to be a backstop, used in rare cases when providers and payers can’t figure out reimbursement themselves. But medical groups and physicians have flooded IDR with significantly more disputes than regulators expected. And providers are overwhelmingly prevailing, winning more than 85% of cases last year, according to government data.

Meanwhile, doctors are often awarded three or four times above comparable in-network rates when they win. In one instance, a plastic surgeon was paid $440,000 for a breast reduction that normally costs around $20,000, according to New York Times reporting earlier this year.

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