Appeals Court Sides with Providers in No Surprises Act Pay Dispute

Katie Adams / medcitynews - A court ruling struck down key parts of how regulators calculate the No Surprises Act’s qualifying payment amount, siding with the Texas Medical Association’s argument that the formula has historically favored payers in arbitration. The post Appeals Court…

AI Summary: An appeals court has sided with providers, striking down the government’s method for calculating the No Surprises Act’s qualifying payment amounts and rejecting parts of the current QPA rule. The decision upends how out-of-network payment disputes are arbitrated, hands leverage back to providers, and injects fresh uncertainty into insurer-provider billing battles.