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Court Strikes Key Arbitration Provision of the No Surprises Act
Diceros Law PLLC Link to more items from this source
Mar. 7, 2022

"[The Texas Medical Association] asserted that the agencies, when issuing their interim final rule, revised the statutory language and created a 'rebuttable presumption' that requires IDR entities to give greater weight to a single statutory factor -- the 'qualifying payment amount' (QPA). The QPA is generally the median of the health plan's contracted rates for the relevant item or service, as calculated by the health plan. This, the TMA argued, will skew IDR results in favor of health plans and undermine providers' ability to obtain adequate compensation for their services. The court agreed with the TMA, finding that 'nothing in the [NSA] instructs arbitrators to weigh any one factor or circumstance more heavily than the others.' " [Texas Medical Assoc. v. HHS, No. 21-0425 (E.D. Tex. Feb. 23, 2022)]

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