Eliott Dear on the Multi-State IDR Practice: NY, TX, NJ, CT, NM, and GA

The Six-State Footprint

Claims Assassins files state IDR submissions in six states: New York, Texas, New Jersey, Connecticut, New Mexico, and Georgia. These are not arbitrary jurisdictions. They are the six states where a provider-side attorney with a qualifying bar admission can file a state IDR submission and expect that a favorable determination will actually be paid by the insurer.

The reason is enforcement. In each of these states, the insurance commissioner or regulatory department has the statutory authority to compel payment of IDR awards and the institutional willingness to use that authority. Insurers in these states treat state IDR determinations as binding. Insurers in non-enforcement states often do not.

Why New York Is the Primary Jurisdiction

New York is the anchor jurisdiction. The New York Department of Financial Services regulates health insurance licenses in the state, and DFS has used its authority on multiple occasions to compel insurers to pay state IDR awards. The reputational and licensing risk to a non-complying insurer is high enough that compliance is the default, not the exception. Claims Assassins files the majority of its submissions in New York.

New York also has the most developed IDR rule set, the longest track record of enforcement, and the clearest FAIR Health benchmark methodology. An Eliott Dear-signed New York state IDR submission carries the weight of two decades of practice in the jurisdiction — every arbitrator on the panel has likely seen the format before.

Texas, New Jersey, Connecticut, New Mexico, and Georgia

Texas has the second-largest state IDR caseload after New York. The Texas Department of Insurance enforces outcomes against carriers licensed in the state. New Jersey operates a state arbitration system with DOBI enforcement. Connecticut has a mediated state process with CID backing. New Mexico and Georgia both run state IDR programs with state insurance commissioner oversight.

The common thread: state regulator, state licensure, state enforcement. Physicians in any of these six states can have Eliott Dear file a properly built state IDR submission against an insurer licensed in that state with confidence that a favorable outcome will be collected.

Why Not Other States

States without a state IDR process or without enforcement authority are not on the Claims Assassins list. In those jurisdictions, the only IDR path is the federal process under the No Surprises Act — and the federal process has a well-documented collection problem. A favorable federal IDR determination does not mean the provider gets paid. Only 1.3% of federal complaints actually close with a paid award on the CMS collection dashboard.

Claims Assassins is built around the six states where an Eliott Dear signature on a state IDR submission is paired with a state regulator that will actually collect on the outcome. The result is a practice that recovers what it files, on files it takes.