No Surprises Act

Federal Regulators Deny Recertification to Two No Surprises Act Arbitration Entities

NSA IDR Navigator™ · November 5, 2026

IPRO and Network Medical Review Company can no longer accept new federal IDR disputes. Parties with cases already assigned to either organization should await further federal instructions.

Why were the two entities denied recertification?

On November 4, the Departments of Health and Human Services, Labor, and the Treasury announced that Island Peer Review Organization, Inc. (IPRO) and Network Medical Review Company, LLC did not meet minimum performance standards. The CMS notice does not specify which standards each entity missed. Eight other entities remain under review; this action does not change their status.

Are the decisions final?

Not yet. Each entity has 30 business days from its written denial notice to request an appeal. The denials become final only after the appeal period ends and any appeal is considered. The restriction on accepting new disputes already applies.

What should providers do about pending cases?

Identify disputes assigned to either entity. Keep selection notices, portal confirmations, offers, supporting submissions, eligibility correspondence, and fee records together with the case deadlines. Await federal instructions before filing a duplicate dispute.

Did provider win rates cause the denials?

CMS did not identify win rates as the reason. The New York Times reported that, according to a Turquoise Health analysis, one affected entity selected the provider’s offer in about 96.5% of its determinations. That percentage alone cannot establish bias: it does not explain the mix of cases, the offers submitted, the evidence available, or whether either party defaulted.

This summary is original informational content based on publicly available reporting and federal materials. It is not a reproduction of the New York Times article and does not constitute legal advice.