Independent Dispute Resolution Process Updated

The departments of Health and Human Services, Labor, and the Treasury (the departments) have updated guidance regarding the No Surprises Act independent dispute resolution (IDR) process. The departments have directed certified IDR entities to resume processing all single and bundled disputes submitted on or before Aug. 3, 2023. 

District Court Disallows Certain Provisions Related to No Surprises Act

For the third time, the U.S. District Court for the Eastern District of Texas ruled to set aside certain regulations implementing the No Surprises Act. The Texas Medical Association, joined by several air ambulance providers and supported by an amicus brief filed by the American Hospital Association, successfully argued that the methodology used to calculate the qualifying payment amount (QPA) favors insurers during the arbitration process.  

CA Supreme Court to Address Whether Hospitals Must Disclose ER Visit Fees Before Treating Patient

For over a decade, at least 15 different class action lawsuits have been filed against California hospitals for failing to disclose their facility fees before patients were treated. The suits claim that hospitals failed to advise patients arriving at their emergency rooms that they would be charged an “evaluation and management services fee” (EMS fee), which violated the state’s unfair competition law (Bus. & Prof. Code § 17200 et seq.) and Consumers Legal Remedies Act (Civ. Code § 1750 et seq.).