Blue Cross Blue Shield of Texas v. HaloMD LLC et al.

Docket No.
26-40316
Appellate Court
Fifth Circuit

Goal

  • Award damages
  • Block defendant action
  • Vacate arbitration awards

Issues

Case History

Why This Matters:

Why this Matters:

A private insurer alleges that a third-party biller is abusing the No Surprises Act arbitration process to receive higher out-of-network payments in violation of the federal Racketeer Influenced and Corrupt Organizations (“RICO”) 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. The plaintiff appeals an order granting the defendants’ motion to dismiss.

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.

9 Major Filings

Related Litigation

Current Status

Briefing is ongoing

Important Date

Defendants' Response Brief Due

Legal Issues

Fraud, Fraudulent Inducement, Negligent Misrepresentation, Racketeer Influenced and Corrupt Organizations ("RICO") Act

Topic(s)

Arbitration Awards/Conduct No Surprises Act

Date Filed
May 22, 2026
Case Type
Civil
Court Type
Appellate Court
Court
Fifth Circuit
Plaintiff(s)
Blue Cross Blue Shield of Texas
Lead Counsel For Plaintiff(s)
Patton, Tidwell & Culbertson
Amicus Briefs for Plaintiff(s)

America’s Health Insurance Plans; American Benefits Council et al.; Employees Retirement System of Texas; Teacher Retirement System of Texas

Plaintiff Type
Insurance Company
Defendant(s)
HaloMD LLC; Alla LaRoque; Scott LaRoque
Lead Counsel for Defendant(s)
Nixon Peabody LLP
Defendant Type
Health Care or Insurance Vendor