- Docket No.
- 7:25-cv-00804
- District Court
- Virginia
Goal
- Award damages
- Award restitution
- Block defendant action
- Declaration that defendants’ actions are unlawful
- Vacate arbitration awards
Issues
Litigation Content
Why this Matters:
The plaintiffs allege that providers and their third-party vendors are abusing the No Surprises Act arbitration process to receive higher out-of-network payments in violation of the federal Racketeering Influenced and Corrupt Organizations (“RICO”) Act, the Employee Retirement Income Security Act, and Virginia law. The higher than expected volume of arbitration cases (including the prevalence of ineligible cases) and high provider win rate could raise health costs and plan premiums.
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.