- Docket No.
- 2:26-cv-07537
- District Court
- New Jersey
Goal
- Award damages
- Block defendant action
- Declaration that defendant action is unlawful
- Vacate arbitration awards
Issues
Litigation Content
Why This Matters:
Why This Matters:
A private health insurer alleges that a third-party biller is exploiting the No Surprises Act’s arbitration process by submitting knowingly ineligible disputes and engaging in abusive billing practices to maximize out-of-network revenue in violation of the No Surprises Act and the New Jersey Insurance Fraud Prevention Act. The higher than expected volume of arbitration cases (including the prevalence of ineligible cases) to date and high provider win rate could raise health costs and plan premiums.
Potential Impact:
Potential Impact:
Actions that flout the intent of the No Surprises Act arbitration process through the submission of ineligible disputes could lead to higher costs and lower-quality care for patients.