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Fifth Circuit Grants En Banc Rehearing in Challenge to QPA Calculation Rules
Reed Smith LLP Link to more items from this source
June 5, 2025

"[T]he Fifth Circuit ... granted a request from plaintiffs ... to vacate and conduct an en banc review of an appellate panel's decision to uphold the government's methodology for determining QPAs and, by extension, compensation for out-of-network providers. If the Fifth Circuit rules differently, MCOs could again be thrown into limbo regarding how to appropriately calculate QPA rates."
[Texas Medical Association (TMA) v. HHS, No. 23-40605 (5th Cir. Oct. 30, 2024; petition for rehearing granted May 30, 2025)]   MORE >>

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