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NO SURPRISES ACT · FEDERAL IDR PROCESS

Fair. Independent. Transparent Dispute Resolution.

CIDRE advances the integrity of the federal Independent Dispute Resolution process - supporting efficient, impartial administration that protects patients from surprise medical bills.

"By protecting the IDR community, we strengthen the broader goal of the No Surprises framework — shielding patients from unexpected medical bills while maintaining a fair and functional healthcare payment system."
CIDRE MISSION STATEMENT

100K+

Disputes via IDR 

$0

Patient liability 

2022

NSA enacted

ABOUT CIDRE

Committed to a Balanced, Independent IDR Process

CIDRE advocates for fair, transparent, and balanced policies that protect the integrity of the processes meant to shield patients from surprise medical billing. We educate lawmakers, regulators, and stakeholders on the operational realities and public value of the IDR system.

Regulatory Stability

Promoting clarity so IDR entities operate efficiently and impartially.

Process Independence

Defending the independence of dispute resolution from undue influence.

Evidence-Based Policy

Maintaining fair balance between providers, payers, and patients.

Stakeholder Education

Informing lawmakers on IDR operational realities and public value.

POLICY PRIORITIES

Our Advocacy Focus

01

Preserving the Role of IDR Entities

Certified IDR entities are foundational to the federal IDR process. CIDRE supports policies protecting their active role across eligibility, administration, and payment determinations. 

02

Legislative Immunity for IDR Entities

Following the 5th Circuit’s 2025 ruling in Guardian Flight, CIDRE advocates for codifying legislative immunity for IDREs in statute to protect neutral arbitration. 

HOW IT WORKS

The IDR Process in Four Steps

1

Open Negotiation

Providers and health plans enter a 30-business-day negotiation period.
2

IDR Initiated

If unresolved, either party initiates the federal IDR process.
3

IDRE Review

A certified neutral entity reviews offers against statutory criteria.
4

Determination

The closest offer to criteria prevails. Patients remain fully protected.
RESEARCH & NEWS

Latest from CIDRE

Get In Touch

Questions about CIDRE’s work or membership?
We’d love to hear from you.
Mary Jane Rodes, Association Manager

2020 Pennsylvania Ave NW, Suite 511
Washington, DC 20006