Ophthalmology and Surgical Institute of Central PA

NorthStar anesthesia providers sue Aetna and Cigna over $4.1M in alleged IDR underpayments. Quick Summary * 33 NorthStar anesthesia providers have filed a lawsuit against Aetna and Cigna. * The case seeks $4.1 million in allegedly unpaid Independent Dispute Resolution (IDR) awards. * NorthStar claims both insurers failed to pay, or paid late without interest, as required by the No Surprises Act (NSA). * The complaint highlights growing provider frustration over payer compliance with IDR determinations. Lawsuit Alleges Pattern of Underpayment and Delay In a lawsuit filed on December 8, 2025, in the U.S. District Court of Connecticut, a group of 33 NorthStar anesthesia providers alleged that Aetna and Cigna failed to comply with binding IDR decisions under the No Surprises Act. The complaint asserts that the two insurers owe more than $4.1 million in total - approximately $2.3 million from Cigna and $1.7 million from Aetna - for services already adjudicated through the federal arbitration process. According to the law, once an IDR entity renders a decision, payment must be made within 30 calendar days. NorthStar alleges that not only did Aetna and Cigna fail to meet this deadline, but they also did not pay interest as required for late reimbursement. The result, NorthStar says, is a growing financial strain on its practices and reduced resources for patient care. "These general business practices deprive NorthStar of the money NorthStar has earned, force NorthStar to expend resources trying to collect the money, and ultimately prevent NorthStar from investing resources in patient care," the complaint reads. Payers Push Back Amid Growing IDR Volume In response, both insurers have pushed back on the narrative. A spokesperson for Aetna claimed that "Congress designed the No Surprises Act to protect American patients from exorbitant, unfair billing practices, not to pad private equity-backed provider profits on the backs of patients." They further asserted that some provider groups are "abusing the arbitration process" for financial gain. Their position aligns with recent public policy concerns. A 2024 report from the Elevance Health Public Policy Institute found that providers prevail in a majority of IDR cases, prompting fears among payers that the arbitration system is being used to inflate reimbursement rates - particularly for out-of-network claims. A System Under Pressure The NorthStar lawsuit underscores a major concern voiced by many providers: even after securing a favorable IDR ruling, collecting payment is not guaranteed. With no centralized enforcement mechanism beyond filing CMS complaints, providers often have limited options when insurers fail to comply. This lawsuit adds to a growing body of litigation suggesting the federal IDR system is breaking down under the weight of payer resistance, high volumes, and inconsistent follow-through. Unless action is taken to enforce payment obligations, the promise of the No Surprises Act may continue to fall short. Why This Matters to Providers Delayed or unpaid IDR awards not only threaten revenue cycles but also undermine confidence in federal arbitration. Providers must: * Track IDR decisions and monitor compliance closely * Document late or missing payments for enforcement * Consider legal recourse when insurers fail to pay This case is likely to resonate across the healthcare industry, especially among out-of-network providers relying on IDR to ensure fair compensation. How Patriot Group Can Help Patriot Group represents healthcare providers navigating complex IDR disputes, reimbursement delays, and audit defense challenges. If your organization is facing insurer noncompliance or IDR underpayment, its legal team can help you secure the payments you're owed and hold payers accountable. Contact Thomas J. Force, Esq., President and Founder of Patriot Group, at [email protected] or call (631) 870-4040.

IRVING, Texas and TAMPA, Fla., May 28, 2025 /PRNewswire/ -- NorthStar Anesthesia, an industry leader in anesthesia care, in April began its new partnership with Tampa General Hospital (TGH) North to provide anesthesia care and management services at three TGH North facilities: Florida Endoscopy and Surgery Center, TGH Spring Hill Hospital, and TGH Brooksville. This partnership is a milestone for NorthStar, as an important partnership in the ever-expanding Florida healthcare market. This partnership will streamline anesthesiology services across all three sites and provide the expert quality care that NorthStar brings to each partnership. Through its partnership with NorthStar, TGH North will expand its service offerings, including a newly introduced cardiac program this fall, alongside other specialized treatment options