Contact

Category: Payor-Provider Disputes

Posted in
Posted in

Payor-Provider Alert: District Courts Turn Away Insurer Challenges to No Surprises Act Awards, and Three Circuits Will Decide Whether the Door Stays Shut

By 0 on Payor-Provider Alert: District Courts Turn Away Insurer Challenges to No Surprises Act Awards, and Three Circuits Will Decide Whether the Door Stays Shut

Anthem Blue Cross Life & Health Insurance Co. v. HaloMD LLC, No. 8:25-cv-01467-KES, 2026 WL 982629 (C.D. Cal. Apr. 9, 2026), appeal docketed, No. 26-2355 (9th Cir. Apr. 16, 2026) | Aetna Health Inc. v. Radiology Partners, Inc., No. 3:24-cv-1343-BJD-LLL (M.D. Fla. Apr. 16, 2026), appeal docketed, No. 26-11607 (11th Cir. May 8, 2026) | […]

CONTINUE READING Payor-Provider Alert: District Courts Turn Away Insurer Challenges to No Surprises Act Awards, and Three Circuits Will Decide Whether the Door Stays Shut 17 min read
Posted in
Posted in

Payor-Provider Case Spotlight: The Third and Ninth Circuits Draw ERISA’s Preemption Line Between the Verification Call and the EOB

By 0 on Payor-Provider Case Spotlight: The Third and Ninth Circuits Draw ERISA’s Preemption Line Between the Verification Call and the EOB

Ahn v. Cigna Health & Life Insurance Co., No. 25-1723, ___ F.4th ___, 2026 WL 1813215 (3d Cir. June 24, 2026), aff’g No. 2:19-cv-07141, 2025 WL 830217 (D.N.J. Mar. 17, 2025) | Healthcare Ally Management of California, LLC v. WSP USA, Inc., No. 24-3479, ___ F.4th ___, 2026 WL 2319896 (9th Cir. Aug. 11, 2026), […]

CONTINUE READING Payor-Provider Case Spotlight: The Third and Ninth Circuits Draw ERISA’s Preemption Line Between the Verification Call and the EOB 13 min read
Posted in
Posted in

Payor-Provider Alert: The Fifth Circuit Holds En Banc What Can and Can’t Be Included in the No Surprises Act’s Qualifying Payment Amount

By 0 on Payor-Provider Alert: The Fifth Circuit Holds En Banc What Can and Can’t Be Included in the No Surprises Act’s Qualifying Payment Amount

Texas Medical Association v. U.S. Department of Health and Human Services, No. 23-40605, ___ F.4th ___, 2026 WL 2322331 (5th Cir. Aug. 11, 2026) (en banc) (per curiam) | Texas Medical Association v. U.S. Department of Health and Human Services, 120 F.4th 494 (5th Cir. 2024), reh’g en banc granted, opinion vacated, 138 F.4th 961 […]

CONTINUE READING Payor-Provider Alert: The Fifth Circuit Holds En Banc What Can and Can’t Be Included in the No Surprises Act’s Qualifying Payment Amount 16 min read
Posted in
Posted in

Payor-Provider Case Spotlight: The Second Circuit Holds That Providers Cannot Sue to Enforce No Surprises Act Arbitration Awards

By 0 on Payor-Provider Case Spotlight: The Second Circuit Holds That Providers Cannot Sue to Enforce No Surprises Act Arbitration Awards

East Coast Advanced Plastic Surgery, LLC v. Cigna Health & Life Insurance Co., No. 25-2204, ___ F.4th ___ (2d Cir. Sept. 17, 2026), aff’g Nos. 25 Civ. 255, 25 Civ. 1686, 2025 WL 2371537 (S.D.N.Y. Aug. 14, 2025) | Guardian Flight, L.L.C. v. Health Care Service Corp., 140 F.4th 271 (5th Cir. 2025) Healthcare / […]

CONTINUE READING Payor-Provider Case Spotlight: The Second Circuit Holds That Providers Cannot Sue to Enforce No Surprises Act Arbitration Awards 13 min read
Contact