Inactive Case

Texas Medical Association et al. v. Department of Health and Human Services et al. (TMA II)

Docket No.
23-40217
Appellate Court
Fifth Circuit

Goal

  • Block enforcement of an agency action
  • Declaration that agency action is unlawful

Issues

Case History

Why this Matters

The plaintiffs argue that regulations to impose guardrails on the No Surprises Act’s arbitration process—a process used to resolve payment disputes for surprise out-of-network bills between payers and out-of-network health care providers—are invalid under the Administrative Procedure Act. In this appeal, the defendants argue that the district court erred in finding that the plaintiffs had standing to challenge the rule and in granting summary judgment for the plaintiffs.

Potential Impact

The inability to impose reasonable guardrails for the No Surprises Act’s arbitration process could lead to abuses of the process and higher health care costs and premiums.

News And Analysis (2)

21 Major Filings

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Related Litigation

Current Status

Decision issued

Legal Issues

Administrative Procedure Act - Contrary to Law, Administrative Procedure Act - Arbitrary and Capricious

Amicus Briefs for Plaintiff(s)

American Society of Anesthesiologists et al.; American Medical Association; American Hospital Association; Physicians Advocacy Institute et al.; Emergency Department Practice Management Association

Amicus Briefs for Defendant(s)

Leukemia & Lymphoma Society et al.; American Benefits Council et al.; America’s Health Insurance Plans; Blue Cross Blue Shield Association

Topic(s)

Arbitration Regulations

Date Filed
April 11, 2023
Case Type
Civil
Court Type
Appellate Court
Court
Fifth Circuit
Judge
King, Carolyn D.; Jones, Edith H.; Oldham, Andrew S.
Plaintiff(s)
Texas Medical Association; Tyler Regional Hospital, LLC; Adam Corley; Lifenet, Incorporated; East Texas Air One, LLC
Lead Counsel For Plaintiff(s)
Sidley Austin LLP
Defendant(s)
Department of Health and Human Services; Department of Labor; Department of the Treasury; Office of Personnel Management, Xavier Becerra, Janet Yellen, Julie A Su, Kiran Ahuja
Lead Counsel for Defendant(s)
Government