- Docket No.
- 26-40316
- Appellate Court
- Fifth Circuit
Goal
- Award damages
- Block defendant action
- Vacate arbitration awards
Issues
Case History
Litigation Content
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.