Trump Administration Launched Surprise Billing Arbitrator Audits
Healthcare providers and insurers face increased scrutiny as regulators move to clean up the disputed payment process.
Updated on Sept. 21, 2026 in Healthcare
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The Centers for Medicare & Medicaid Services has launched a new program to audit independent dispute resolution arbitrators following the 2022 implementation of the No Surprises Act. The federal effort aims to address long-standing concerns regarding the integrity of the process used to settle out-of-network payment conflicts.
Why it matters
The audit program targets significant litigation and reported misconduct involving both medical providers and insurance companies in the arbitration process. These enforcement actions are designed to stabilize a system that contributed to higher medical spending since its inception.
The Centers for Medicare & Medicaid Services is initiating these audits following years of reported friction in the No Surprises Act dispute process. While the total number of arbitrators subject to initial review is unknown, the initiative reflects a federal response to rising costs.
The players
Centers for Medicare & Medicaid Services
The federal agency responsible for administering Medicare, Medicaid, and enforcing the regulatory provisions of the No Surprises Act.
Donald Trump
The current President of the United States who oversees the federal agencies implementing healthcare regulatory audits.
The details
The No Surprises Act bars clinicians from balance-billing patients for unexpected costs during emergency care or procedures at in-network facilities. When providers and insurers disagree on the fair reimbursement rate for these services, they use an independent dispute resolution process to settle the conflict. The new audits examine whether arbitrators have adhered to federal regulations when mediating these payment disagreements.
Timeline
The No Surprises Act took effect in 2022.
The Trump administration launched the audit program in September 2026.
Market Landscape
This program represents the federal government's shift toward active enforcement of the No Surprises Act to curb rising medical spending. It follows a period of intense litigation and market volatility that challenged the initial implementation of the law.
Operators in the medical billing and insurance spaces should prepare documentation for potential reviews by federal auditors. Management should consult with legal counsel to ensure that arbitration strategies remain compliant with all current federal guidelines.
The takeaway
The audit program signals that the federal government is prioritizing the professional conduct of arbitrators to manage healthcare spending. Review internal records of recent arbitration filings to ensure compliance with the latest oversight standards defined by the Centers for Medicare & Medicaid Services.
Further reading
For additional context on regulatory developments, visit our Healthcare section.
Live Poll
Should the federal government increase oversight of medical billing disputes to control healthcare costs?
