In a recently issued opinion, the Fifth Circuit has added yet another chapter to the growing debate over whether providers may seek judicial enforcement of Independent Dispute Resolution (“IDR”) awards issued under the No...more
6/30/2025
/ Appeals ,
Arbitration Awards ,
Department of Health and Human Services (HHS) ,
Dispute Resolution ,
Federal Arbitration Act ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Insurance Industry ,
Insurance Litigation ,
Judicial Review ,
No Surprises Act (NSA) ,
Statutory Interpretation
The U.S. Supreme Court has issued a significant ruling affecting hospitals that serve low-income Medicare beneficiaries, narrowing the interpretation of the Disproportionate Share Hospital (“DSH”) payment formula. In...more
5/23/2025
/ Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Government Agencies ,
Health Care Providers ,
Healthcare ,
Healthcare Facilities ,
Hospitals ,
Medicaid ,
Medicare ,
Reimbursements ,
SCOTUS ,
Statutory Interpretation ,
Supplemental Security Income (SSI)
In a victory for Texas health care providers, in Baylor All Saints Medical Center dba Baylor Scott & White All Saints Medical Center‑Fort Worth et al. v. Xavier Becerra, case number 4:24‑cv‑00432, the United States District...more
9/11/2024
/ Administrative Procedure Act ,
Chevron Deference ,
Declaratory Relief ,
Department of Health and Human Services (HHS) ,
Disproportionate Share Adjustments ,
Exclusions ,
Federal Trade Commission (FTC) ,
Final Rules ,
Health Care Providers ,
Hospitals ,
Loper Bright Enterprises v Raimondo ,
Medicaid ,
No Surprises Act (NSA) ,
Permanent Injunctions ,
Provider Reimbursement Review Board ,
Texas
In a recent win for health care providers, the United States Court of Appeals for the Fifth Circuit has affirmed a lower court’s decision to vacate key portions of regulations issued by the U.S. Departments of Treasury,...more
8/16/2024
/ Administrative Procedure Act ,
Appeals ,
Appellate Courts ,
Chevron Deference ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Dispute Resolution ,
Health Care Providers ,
Loper Bright Enterprises v Raimondo ,
No Surprises Act (NSA) ,
Out of Network Provider ,
Payment Systems ,
Regulatory Standards ,
SCOTUS ,
U.S. Treasury ,
Vacated