EmblemHealth, Inc. v. Rowe et al.

Docket No.
2:26-cv-03311
District Court
New Jersey

Goal

  • Award damages
  • Declaration that defendant action is unlawful
  • Vacate arbitration awards

Litigation Content

Why This Matters:

Why This Matters:

A private insurer alleges that a plastic surgeon and his practice are abusing the No Surprises Act arbitration process to obtain significantly higher out-of-network payments for breast reduction surgeries. The higher than expected volume of arbitration 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 could lead to higher costs and lower-quality care for patients.

1 Major Filings

Litigation Information

Current Status

Briefing is ongoing