The status of 8 No Surprises Act lawsuits

Eight lawsuits have been filed challenging the No Surprises Act since December, Health Affairs reported June 6. 

The cases have been filed by the following:

  • Texas Medical Association and Adam Corley, MD
  • Association of Air Medical Services 
  • American Medical Association, American Hospital Association, Renown Health, UMass Memorial Health, Stuart Squires, PhD, and Victor Kubit, MD 
  • American Society of Anesthesiologists, American College of Emergency Physicians, American College of Radiology 
  • Georgia College of Emergency Physicians and Brett Cannon, MD
  • Daniel Haller, MD, and Long Island Surgical PLLC 
  • LifeNet (an air ambulance company) 
  • PHI Health (an air ambulance company) and Empact Midwest (an emergency room physician staffing firm)

All eight of the lawsuits challenge an interim final rule on independent dispute resolution, according to the report. The lawsuits take issue with the rule's requirement that independent dispute resolution entities presume the qualifying payment amount — the insurer or plan’s median in-network rate — is the appropriate out-of-network payment amount. 

A court decision has only been reached in one of the eight cases. In the Texas Medical Association case, the judge ruled in its favor, saying the rule "places its thumb on the scale" for the qualifying payment amount. HHS appealed the decision April 22 but later asked the court to hold its appeal until it releases the final surprise-billing rule this summer. 

The American Society of Anesthesiologists and Georgia College of Emergency Physicians cases are also on hold, according to the report. 

The other cases are proceeding, according to the report. There may soon be a preliminary decision in Dr. Haller's case, which has a hearing June 7.

The American Medical Association and Association of Air Medical Services cases were consolidated into one case this year. A hearing was held March 21. The report's author, Katie Keith, said she attended the hearing and left with the impression that the case's judge was not inclined to issue a ruling before the final independent dispute resolution rule from the Biden administration. 

Ms. Keith is director of the Health Policy and the Law Initiative at the O’Neill Institute for National and Global Health Law at Georgetown University Law Center.

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