No Surprises Act Handed Another Legal Jolt

The latest action comes as the beleaguered legislation has been the subject of five lawsuits.

The U.S. District Court for the Eastern District of Texas delivered a summary judgement that vacated – really, repealed – some of the sections of the No Surprises Act’s Part 2 Regulation. 

The Court’s decision from last week hands healthcare providers a win when it comes to the arbitration process, because, under the ruling, the arbitrator now has to consider five different factors instead of just one when deciding what the proper reimbursement should be.

Under the ruling, providers will be able to argue to the arbitrator that their reimbursement should be higher than the in-network rate.  

Programming Note: Listen to Matthew Albright and healthcare attorney David Glaser report on this latest action Monday on Monitor Mondays.

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Matthew Albright

Matthew Albright is the chief legislative affairs officer at Zelis Healthcare. Previously, Albright was senior manager at CAQH CORE, and earlier, he was the acting deputy director of the Office of E-Health and Services for the Centers for Medicare & Medicaid Services.

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