A California federal judge on Monday dismissed all claims in Anthem Blue Cross of California's lawsuit against HaloMD, which manages independent dispute resolutions under the federal No Surprises Act. Anthem alleged that HaloMD had exploited the resolution process to submit ineligible claims and secure higher out-of-network payment awards.
Judge Karen E. Scott of the U.S. District Court for the Central District of California ruled that the No Surprises Act's limitations on judicial review preclude the courts from second-guessing independent dispute resolution eligibility and award determinations. She referred to one of Anthem's failed attempts to convince the court otherwise as "a novel argument unsupported by any case law. [Anthem's] theories are all end runs around the NSA's limits on judicial review."
HaloMD became the largest user of the NSA arbitration process in the first half of 2025, handling thousands of disputes. Anthem alleged that HaloMD and affiliated providers submitted more than 1,500 proceedings between January 2024 and August 2025, of which nearly half were ineligible for arbitration. Anthem said the submission volume was deliberate and designed to overwhelm claims staff and confuse arbitrators into rubber-stamping inflated payment awards.
The ruling strengthens the No Surprises Act's arbitration framework and limits insurers' ability to litigate unfavorable arbitration outcomes, according to HaloMD. Justin Carangelo, general counsel for the company, called the ruling a broader win for the health care system.
"The No Surprises Act was passed to protect patients and ensure fair reimbursement for out-of-network care," he said in a news release. "This decision defends the integrity of that system. We are grateful the court recognized that allowing insurers to relitigate every unfavorable arbitration outcome in federal court would completely undermine congressional intent."
A spokesperson for Elevance Health, the parent company of Anthem, disagreed.
"We believe it misinterprets the No Surprises Act and improperly limits judicial review, and we intend to appeal with confidence in our position," the spokesperson said, according to Becker's Hospital Review. "Elevance Health will continue to hold billing companies and out-of-network providers accountable for practices that we believe drive up health care costs and burden consumers as we work to support the intent of the No Surprises Act and advance a health care system that is transparent, fair and drives down the cost of care for the people we serve."
Although the ruling is a victory for HaloMD, other lawsuits against the company remain pending in states such as Georgia, Ohio and Texas.
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