Elevance subsidiary loses No Surprises Act lawsuit

Elevance subsidiary loses No Surprises Act lawsuit Complaint alleged corruption by HaloMD, a company that handles the arbitration process for medical billing disputes. Compliance & Legal By Susan Morse , Executive Editor | April 15, 2026 | 10:48 AM Photo: Costella/Getty Images An Elevance subsidiary has lost a lawsuit in the No Surprises Act Independent Dispute Resolution process.A federal judge in California dismissed the lawsuit by Elevance Health subsidiary Anthem Blue Cross Life and Health Insurance Company, against billing dispute consultant HaloMD and provider plaintiffs MPOWERHealth Practice Management, Bruin Neurophysiology and Sound Physicians Emergency Medicine of Southern California. HaloMD administers IDR proceedings on behalf of healthcare providers.Anthem accused HaloMD of obtaining inflated reimbursements through the No Surprises Act's independent dispute resolution (IDR) system.In the civil lawsuit brought in July 2025, Anthem alleges violations by the LaRoque Family Providers, owner of HaloMD. It made accusations of mail and wire fraud in submitting ineligible billing disputes to the IDR process.According to Anthem, “Plaintiffs allege that Defendants use three ‘tactics’ to turn the NSA’s IDR process ‘into a vehicle for fraud.’"Anthem said it was seeking judicial review of Defendants’ NSA schemes, and not any individual IDR payment determination.Judge Karen Scott dismissed the suit, ruling that Anthem Blue Cross did not show sufficient evidence of misuse of the IDR system by HaloMD or the other defendants.HaloMD is fighting lawsuits from four different Blue Cross Blue Shield insurers accusing it of rigging the system and triggering huge payouts for itself and its provider clients, according to STAT. Alla and Scott LaRoque founded the LaRoque Family Providers and have profited off the No Surprises Act law, the report said. The LaRoques have denied the allegations, STAT said. Topic: Accounting & Financial Management, Billing and Collections, Business Intelligence, Compliance & Legal