California court dismisses Anthem NSA IDR challenge

A California federal court has dismissed Anthem Blue Cross claims against HaloMD and several physician groups over No Surprises Act independent dispute resolution awards.

The case was filed in July 2025 by Anthem Blue Cross Life and Health Insurance Company and Blue Cross of California, doing business as Anthem Blue Cross. Defendants included HaloMD, MPOWERHealth Practice Management, Bruin Neurophysiology, iNeurology, N Express, North American Neurological Associates, and Sound Physicians entities.

Anthem sought to vacate IDR determinations and brought claims tied to the NSA process. The court said the No Surprises Act created a framework for open negotiation, IDR proceedings, and payment determinations by certified IDR entities.

Judge Karen E. Scott granted motions to dismiss without leave to amend. The court said Anthem had not shown an authorized basis for the district court to vacate IDR determinations.

The court also dismissed remaining federal claims for lack of subject-matter jurisdiction. It declined to exercise supplemental jurisdiction over state-law claims.

The order rejected Anthem’s position that disputed eligibility determinations should be reviewed in federal court. The court said that approach would make “nearly every eligibility determination” disputed by an IDR participant subject to court review.

The court said that result would be inconsistent with the NSA’s streamlined IDR process and its limits on judicial review. It also noted that certified IDR entities are directed to determine whether the federal IDR process applies.

The American College of Radiology highlighted the ruling April 20. ACR said the decision stopped a payer effort to use court challenges against the NSA dispute process established by Congress and regulators.

Anthem filed a notice of appeal April 13, according to the Health Care Litigation Tracker.