This post has been archived and contains information that may be out of date.
A Texas District Court has again ruled in favor of hospitals and providers in a suit brought by the Texas Medical Association challenging the Biden administration’s Aug. 19, 2022, final rule involving the No Surprises Act.
The suit targeted regulations that instructed arbiters to consider the qualifying payment amount (QPA) first, before considering other factors enumerated by the statute. Those factors included patient acuity, provider training, market share, teaching status, and good faith efforts to contract. The regulations also called on arbiters to only consider the other permissible factors if they were not already accounted for by the QPA.
The judge in the case found the administration’s final rule conflicted with the plain statutory language of the No Surprises Act (NSA) and “continues to place a thumb on the scale for the QPA.” The ruling vacates on the national level portions of the final rule that continued to instruct arbiters to favor the QPA. However, it does not affect other provisions of the NSA such as patient protections. The administration can appeal this ruling.