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Supreme Court Declines Review of No Surprises Act IDR Enforcement Dispute
The U.S. Supreme Court has declined to review a Fifth Circuit decision addressing whether the No Surprises Act permits providers to bring private lawsuits to enforce independent dispute resolution (IDR) awards against insurers. The Court’s rejection leaves intact a June 2025 ruling holding that providers may not seek to enforce IDR awards through private court actions.
In Guardian Flight LLC v. Health Care Service Corp., the Fifth Circuit concluded that Congress intended enforcement of the No Surprises Act to occur through administrative penalties rather than private litigation. The Fifth Circuit panel also rejected related ERISA claims, reasoning that providers lack standing to bring derivative ERISA claims because the beneficiaries could not suffer a concrete injury as the No Surprises Act shields beneficiaries from liability for any out-of-network costs.
By declining to take up the case, the Supreme Court leaves unresolved broader questions about how providers can compel payment of IDR awards when insurers allegedly fail to pay. The decision leaves continued uncertainty surrounding the federal IDR framework and may prompt providers to reassess their reliance on the IDR process.
A copy of the petition is available here.
Reporters, Dennis Mkrtchian, Los Angeles, + 1 213 218 4046, dmkrtchian@kslaw.com, Amanda Hayes-Kibreab, Los Angeles, + 1 213 444 4375, ahayes-kibreab@kslaw.com
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In fiscal year 2025, the Department of Justice (DOJ) secured the largest total of False Claims Act (FCA) settlements and judgments ever recorded in a single year, exceeding $6.8 billion for the year ending on September 30, 2025. Filings reached a record of 1,297 qui tam lawsuits, and the government opened 401 investigations. The DOJ continued to focus on healthcare-related matters, with related settlements and judgments exceeding $5.7 billion in 2025. Since Congress strengthened the civil FCA in 1986, total settlements and judgments have surpassed $85 billion. Representative examples of matters can be found in DOJ’s fact sheet available here, and official statistics can be found here. The full DOJ press release is available here.
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