How the No Surprises Act’s Dispute System Works — and How Anthem Says It Was GamedThe No Surprises Act eliminated surprise bills for patients. Multiple insurer-hospital disputes involving the No Surprises Act IDR process are working through federal courts simultaneously. What This Means for California Patients With Anthem CoverageAnthem Blue Cross serves approximately 40 million members in 14 states. In California, Anthem is one of the largest health insurers through its Blue Cross of California and Anthem Blue Cross operations. Prime Healthcare’s 11 California hospitals include facilities in the Inland Empire, the San Gabriel Valley, and Northern California.