New York’s IDR System Preserves Access to Care
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In a recent segment on Capitol Pressroom, MSSNY EVP Dr. Thomas Lee delivered a clear message: New York’s Independent Dispute Resolution (IDR) process is not broken—it is essential.
At a time when insurers are pushing to scale back the state’s out-of-network billing protections, IDR serves as a critical safeguard for both patients and physicians. The system allows independent arbitrators to resolve payment disputes, ensuring doctors are not forced to accept unfairly low reimbursements.
“This is one of the only ways physicians can challenge underpayment,” Dr Lee explained, emphasizing that without IDR, insurers would effectively dictate rates with little accountability.
Insurers have claimed that the process contributes to rising healthcare costs, but Dr Lee pushed back strongly. “The narrative that this is driving costs is misleading,” he said, pointing instead to the role IDR plays in maintaining balance in negotiations between providers and insurance companies.
Crucially, the system was designed with patients in mind. “Patients are held harmless in this process,” Dr Lee noted, underscoring that New Yorkers are protected from surprise medical bills while disputes are handled behind the scenes.
Dr Lee also described IDR as “a structured, independent process,” reinforcing MSSNY’s position that the system is both fair and necessary. Weakening it, advocates warn, would tilt the scales heavily in favor of insurers—potentially forcing physicians to limit services or leave networks altogether.
Preserving IDR means preserving access to care, particularly in underserved and rural areas. The process is not just about payment disputes—it is about ensuring that patients across New York can continue to receive timely, quality medical care without financial uncertainty.
