California Judge Dismisses Anthem Lawsuit, Citing No Surprises Act Limits on IDR Review

Overview

• A federal judge in California threw out Anthem’s case against HaloMD, finding that courts cannot redo eligibility or awards issued through the law’s independent dispute resolution (IDR) process.
• Elevance, Anthem’s parent company, said it strongly disagrees with the ruling, called it procedural, and said it will appeal.
• Anthem had alleged HaloMD and affiliated providers filed more than 1,500 IDR disputes from January 2024 to August 2025, with roughly 47% ineligible and a plan to overwhelm claims staff and arbitrators.
• The lawsuit leaned on RICO, ERISA, fraud, and state-law claims to try to void arbitration results, but the court said Congress set narrow review paths that do not allow broad second-guessing of IDR decisions.
• The ruling bolsters the finality of IDR in out-of-network payment fights, a flashpoint where providers see a check on underpayment and insurers warn about higher costs and pursue similar cases in other states.