The No Surprises Act: A Cost Saving Opportunity for Employer Plan Sponsors
Surprise! What Hospices Need to Know About the No Surprises Act
Make sure you’re providing good faith estimates to uninsured & self-pay patients - Under the No Surprises Act, healthcare providers are required to offer Good Faith Estimates (GFEs) to self-pay and uninsured patients...more
On May 27, 2025, Blue Cross Blue Shield Healthcare Plan of Georgia (“BCBSGA”) sued several emergency physician groups and their billing agent, Halo MD, alleging abuse of the No Surprises Act’s (“NSA”) independent dispute...more
The Fifth Circuit and the Federal District Court of Connecticut have issued conflicting decisions on whether service providers may sue to enforce arbitration awards under the No Surprises Rules in the Consolidated...more
There has been a flurry of recent activity in a case originally filed by six air ambulance companies claiming $20 million in unpaid emergency services invoices. ...more
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
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
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
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
News Briefs - Appeals Court Set to Rehear No Surprises Case - An appeals court is set to rehear a case from providers trying to restrict what factors insurers consider in calculating a key metric that arbiters use to...more
The U.S. District Court for the District of Connecticut has become the latest court to weigh in on whether Independent Dispute Resolution (“IDR”) awards issued under the No Surprises Act (“NSA”) are enforceable. In a recent...more
A recent decision from the US District Court for the Eastern District of New York has significant implications for providers navigating the No Surprises Act (NSA) independent dispute resolution (IDR) process....more
UPDATE: On May 30, 2025, the Fifth Circuit granted the TMA III plaintiffs’ petition for rehearing en banc, which was previously filed on December 16, 2024. Of note, the Fifth Circuit’s mandate has not yet been issued, so as a...more
On May 27, Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. (BCBSGA) filed a lawsuit in the Northern District of Georgia US District Court, alleging that a group of health care providers, along with their third-party...more
Health Policy Fireside Chat: What to Expect from the New Administration - Bill Mathias, Member at Bass, Berry & Sims, engaged in a fireside chat with Colin Roskey, Principal at FHP Strategies, former Deputy Assistant...more
On January 14, 2025, the US Departments of Labor, Health and Human Services (HHS), and the Treasury (collectively, the Departments), along with the Office of Personnel Management (OPM), jointly issued Part 69 of a series of...more
ERISA Health Plan clients are engaged in nearly every industry in the United States. There are nearly 139 million Americans covered by ERISA Health Plans and 2.5 million Health Plans. Yet, operating a health plan has become...more
Our Employee Benefits & Executive Compensation Group discusses new guidance for group health plans and insurers on complying with federal gag clause prohibitions and No Surprises Act requirements....more
The No Surprises Act, a law that ended the practice of “balance billing” by certain out-of-network providers, was enacted as part of the Consolidated Appropriations Act of 2021 on December 27, 2020. While the law passed...more
Welcome to our seventh issue of The Health Record - our healthcare law insights e-newsletter. This will be our final issue of 2024. When we started this publication earlier this year, our goal was to provide our clients,...more
The Fifth Circuit Court of Appeals has handed down a significant decision in response to a challenge from health care providers to the implementing regulations of the No Surprises Act (“NSA”). The Court upheld the...more
Share 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...more
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
We are now in September! And while many folks are thinking about how summer has come and gone so quickly, those following the No Surprises Act implementation process may also be wondering how a whole year has passed since the...more
The Fifth Circuit Court of Appeals has affirmed the invalidity of regulations governing the independent review process under the No Surprise Billing Rules....more
As one of the more toxic topics in the United States political and social realms, healthcare, and the debt associated with it, is always at the tip of most people’s tongue. Whether eagerly waiting to argue for proposed...more