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Proskauer - Health Care Law Brief

No Surprises Here! Fifth Circuit Holds NSA Provides No Private Right of Action to Enforce IDR Awards, Deepening Judicial Divide...

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

King & Spalding

Fifth Circuit Finds No Private Right of Action for Providers to Enforce Surprise Billing Awards

King & Spalding on

On Thursday, June 12, 2025, a panel of the United States Court of Appeals for the Fifth Circuit issued two rulings construing parts of the No Surprises Act (NSA) to limit judicial review of arbitration awards issued under the...more

ArentFox Schiff

Federal Courts Divided Over Private Enforcement of ‘No Surprises Act’ Arbitration Awards

ArentFox Schiff on

Congress enacted the No Surprises Act (NSA) to protect patients from unexpected medical bills. A central pillar of the NSA is its independent dispute resolution (IDR) process, under which payers and providers can submit...more

Troutman Pepper Locke

Fifth Circuit Clarifies Enforcement of IDR Awards Under the No Surprises Act

Troutman Pepper Locke on

On June 12, the U.S. Court of Appeals for the Fifth Circuit issued a significant opinion in the case involving Guardian Flight, LLC and Med-Trans Corporation, two air ambulance providers, against the defendant insurance...more

Marshall Dennehey

Treatment With Authorized Provider Tolls Statute of Limitations, Although Treatment Occurred Without Employer/Carrier’s Knowledge...

Marshall Dennehey on

Ortiz v. Winn-Dixie, Inc., No. 1D2021-0885, Fla. 1st DCA 2024, DCA#: 1D2021-0885, Decision date: Dec. 23, 2024 - The First District Court of Appeal issued another opinion in the ongoing statute of limitations saga triggered...more

Harris Beach Murtha PLLC

"No Surprises Act" Ruling Favors Regulators, Insurers

Federal regulators recently won a large legal victory when the Fifth Circuit Court of Appeals upheld several provisions of the rule regulating Qualified Payment Amount (“QPA”) calculations under the No Surprises Act (the...more

Verrill

Surprise Medical Bills: Texas District Court Vacates Portion of Independent Dispute Resolution (IDR) Process in Agency Rule

Verrill on

The U.S. District Court for the Eastern District of Texas recently vacated a portion of the Requirements Related to Surprise Billing, Part II, Interim Final Rule (the “Rule”) regarding the independent dispute resolution (IDR)...more

Steptoe & Johnson PLLC

The West Virginia Medical Professional Liability Act Applies Broadly to Services Encompassing Patient Care – Not Just the Care...

Steptoe & Johnson PLLC on

The Supreme Court of Appeals of West Virginia issued a new opinion that finds that litigants cannot characterize claims as “corporate” or “general” negligence in an attempt to circumvent the West Virginia Medical Professional...more

K&L Gates LLP

K&L Gates Triage: Michael P. V. BCBS Of Texas

K&L Gates LLP on

In this week’s episode, Gary Qualls discusses a recent case decided in the Western District of Louisiana, which highlights how the application of the arbitrary and capricious standard as applied to payor coverage...more

Faegre Drinker Biddle & Reath LLP

Third Cir. Holds Hospitals May Sue Health Insurers Directly

Before September 11 the Third Circuit Court of Appeals had been out of step with its sister federal circuits when it came to the right of hospitals, physicians and other health providers to sue health insurers that failed to...more

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