- Docket No.
- 2:26-cv-01175
- District Court
- Pennsylvania Western
Goal
- Award damages
- Award restitution
- Block defendant action
- Vacate arbitration awards
Issues
Litigation Content
Why This Matters:
Why This Matters:
A nonprofit health insurer alleges that a health care provider that offers neuromonitoring services and a third-party biller are abusing the No Surprises Act arbitration process to receive higher out-of-network payments by submitting ineligible claims and making misrepresentations about the claims to the arbitrator. 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.
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.