Potential Impact:
Why this Matters:
The plaintiffs argue that regulations to impose guardrails and increase administrative fees with respect to 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. If federal agencies cannot set reasonable guidelines and devise a sustainable funding model to support arbitrators, certain providers could be more likely to try to abuse this process to obtain higher payments, making the arbitration process more likely to become inflationary, and leading to higher health care costs and premiums.
Potential Impact:
The inability to impose reasonable guardrails and administrative fees for the No Surprises Act’s arbitration process could lead to abuses of the process and higher health care costs and premiums.
Texas Medical Association et al. v. Department of Health and Human Services et al. (TMA IV)
Goal
Issues
Litigation Content
Potential Impact:
Why this Matters:
The plaintiffs argue that regulations to impose guardrails and increase administrative fees with respect to 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. If federal agencies cannot set reasonable guidelines and devise a sustainable funding model to support arbitrators, certain providers could be more likely to try to abuse this process to obtain higher payments, making the arbitration process more likely to become inflationary, and leading to higher health care costs and premiums.
Potential Impact:
The inability to impose reasonable guardrails and administrative fees 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 (1)
Health Affairs
The No Surprises Act: A Litigation Status Check14 Major Filings
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JUDGMENT (Aug 3, 2023)
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ORDER ON PLAINTIFFS' MOTION FOR SUMMARY JUDGMENT AND DEFENDANTS' CROSS MOTION FOR SUMMARY JUDGMENT (Aug 3, 2023)
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DEFENDANTS' REPLY RE: CROSS MOTION FOR SUMMARY JUDGMENT (Apr 7, 2023)
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PLAINTIFFS' RESPONSE TO MOTION FOR SUMMARY JUDGMENT AND REPLY RE: MOTION FOR SUMMARY JUDGMENT (Mar 27, 2023)
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DEFENDANTS' CROSS MOTION FOR SUMMARY JUDGMENT AND RESPONSE TO PLAINTIFFS' MOTION FOR SUMMARY JUDGMENT (Mar 15, 2023)
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DEFENDANTS' CROSS MOTION FOR SUMMARY JUDGMENT AND RESPONSE TO MOTION FOR SUMMARY JUDGMENT (Mar 15, 2023)
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AMICUS BRIEF [THE EMERGENCY DEPARTMENT PRACTICE MANAGEMENT ASSOCIATION] (Feb 21, 2023)
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AMICUS BRIEF [AMERICAN SOCIETY OF ANESTHESIOLOGISTS ET AL.] (Feb 21, 2023)
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RELATED CASES (Feb 15, 2023)
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PLAINTIFFS' MOTION FOR SUMMARY JUDGMENT (Feb 13, 2023)
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SCHEDULING ORDER (Feb 13, 2023)
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JOINT MOTION TO SET AN EXPEDITED SUMMARY JUDGMENT BRIEFING SCHEDULE (Feb 10, 2023)
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PLAINTIFFS' NOTICE OF RELATED CASES (Jan 30, 2023)
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COMPLAINT (Jan 30, 2023)
View MoreRelated Litigation
Litigation Information
Current Status
Decision issued
Legal Issues
Administrative Procedure Act - Notice and Comment Violation, Administrative Procedure Act - Without Observance of Procedure Required by Law, Administrative Procedure Act - Contrary to Law, Administrative Procedure Act - Arbitrary and Capricious
Topic(s)
Arbitration Regulations
Litigation Metadata
American Society of Anesthesiologists et al.; Emergency Department Practice Management Association