Why Is the IDR Process Different in Florida, and How Has It Evolved Due to Recent Advocacy Efforts?

October 5, 2026

In this Zotec Answers episode, Ed Gaines and Dr. Eliot Goldner break down Florida’s out-of-network claims dispute process, how it differs from the federal No Surprises Act IDR process, and why recent advocacy efforts matter for physicians and clinicians.

Access and Fair Reimbursement in Florida’s IDR Process

Ed Gaines, Vice President of Regulatory Affairs and Industry Liaison at Zotec Partners, welcomes Dr. Eliot Goldner, an emergency medicine physician in Orlando, Florida, and board member of the Florida College of Emergency Physicians, to answer the question: Why is the IDR process different in Florida, and how has it evolved due to recent advocacy efforts? Together, Ed and Dr. Goldner explain how Florida’s state-specified law fits within the No Surprises Act, why the federal IDR process acts as a backstop when no state process applies, and how Florida physicians worked together to address payer opt-outs that were limiting access to the state dispute resolution process. They also discuss the power of coordinated advocacy across emergency medicine, radiology, anesthesia, and other hospital-based specialties to protect fair reimbursement, strengthen physician voices, and support the business of healthcare.

Key topics include:

• How Florida’s state-specified law applies to certain out-of-network claims
• Why the No Surprises Act does not replace valid state dispute resolution processes
• The difference between state-regulated plans and ERISA plans in IDR
• How payer opt-outs weakened Florida’s process over time
• Why advocacy was needed to clarify and preserve the state process
• How FCEP, EDPMA, radiology, and other physician groups worked together
• Why coalition-building is critical in healthcare policy
• What other states can learn from Florida’s IDR advocacy win
• Why physician engagement remains essential to fair reimbursement and patient access

Ed and Dr. Goldner also highlight the importance of continued vigilance as insurers, regulators, and lawmakers respond to evolving No Surprises Act implementation.

Ready to Learn More?

For more on the No Surprises Act and physician reimbursement, listen to our previous Zotec Answers episode, “Who Is Really ‘Gaming’ Who in the NSA?”

As the November 3 midterm elections approach, listeners can access Zotec’s free, nonpartisan Election Center by clicking here or by texting ZPVOTE to 50457 to review voter registration information, ballot details, polling locations, and more.

About ZPAC: the Zotec Political Advocacy Committee (ZPAC), dedicates itself to making a difference for physicians and healthcare administrators nationwide. ZPAC advocates for equitable access to healthcare services for all individuals. Stay informed and engaged with ZPAC by following our podcast episodes, blog posts, and speaking engagements on our active Twitter/X and LinkedIn profiles. Together, we can shape policies that support healthcare providers and promote equitable access to quality care for all. To learn more about Zotec Partners, visit our website here.