Quick facts
- What: Recertification denied for Island Peer Review Organization (IPRO) and Network Medical Review Company
- Why: The Departments (HHS, Labor and Treasury) found they failed to meet minimum performance standards
- Effect: Neither can accept new disputes. Both may appeal
- Open cases: CMS says parties should expect further guidance on next steps
- Date: Announced November 4, 2026
What is IDR, in plain English?
When you treat a patient out-of-network in a situation covered by the No Surprises Act, like many emergency services or certain care at in-network facilities, you can't bill the patient for the difference. If you and the health plan can't agree on payment, either side can take it to federal independent dispute resolution. A certified IDR entity acts as the referee and picks one side's offer.
What happened?
The federal Departments reviewed the certified IDR entities and denied recertification to two of them, IPRO and Network Medical Review Company, for failing minimum performance standards. Both are marked on CMS's list as not accepting new disputes. Both can appeal, and Network Medical Review has said it will, according to STAT. The other eight certified entities have finished their petition periods, and the Departments are reviewing those petitions.
This matters to providers because, according to STAT's reporting, IPRO was an arbitrator that frequently ruled in clinicians' favor.
How does this affect my practice?
New disputes: you can't send new cases to IPRO or Network Medical Review. Expect cases to be spread across the remaining entities, which could mean different timelines and outcomes.
Open disputes: if you have cases pending with either entity, CMS says to expect more guidance. Don't let any of your own deadlines slip while you wait.
Cash flow: slower dispute resolution means slower out-of-network payment. Plan for it if IDR is a meaningful part of your revenue.
What should I do now?
How HealthRescue Partners can help
We track out-of-network payments, work underpaid claims and can help you decide whether a payer contract makes more sense than repeated disputes. See A/R follow-up and denial management (15% of what we recover), insurance contract negotiation ($500) and credentialing ($150 per payer).
Frequently asked questions
Which IDR entities lost certification in November 2026?
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Island Peer Review Organization (IPRO) and Network Medical Review Company. The Departments denied their recertification on November 4, 2026 for failing to meet minimum performance standards.
Can I still send No Surprises Act disputes to IPRO?
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No. CMS lists both IPRO and Network Medical Review Company as not accepting new disputes.
What happens to my open IDR disputes with IPRO or Network Medical Review?
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CMS says parties with open disputes should expect further guidance from the Departments on next steps. Watch the CMS No Surprises notices page.
Can IPRO and Network Medical Review appeal?
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Yes. Both entities may appeal the decision, and Network Medical Review has said it will appeal.
Sources
This article explains payer and CMS rules in plain language for practice owners. It is not legal advice. Rules can change after publication, so always confirm against the source document before changing how you bill. Last reviewed November 9, 2026.