Med-Trans Corporation v. Capital Health Plan, Inc. et al.

Why this Matters

The plaintiff, an air ambulance provider, sued a health insurer and arbitration entity following the resolution of the No Surprises Act’s arbitration process—a process used to resolve payment disputes for surprise out-of-network bills between payers and out-of-network health care providers. The plaintiff argues that the arbitration award should be set aside and the dispute reheard due to unlawful misrepresentations and the application of an illegal presumption in favor of the qualifying payment amount. The No Surprises Act provides for strict limitations on the judicial review of arbitration awards to facilitate a swift and cost-efficient resolution of disputes between payers and providers.

Potential Impact

Drawing arbitration entities directly into burdensome lawsuits frustrates the intent of an efficient arbitration process to swiftly resolve disputes under the No Surprises Act in a cost-efficient manner.