A federal judge for the fourth time sided with the Texas Medical Association in legal challenges over the No Surprises Act.
The Texas Medical Association filed a lawsuit in November arguing that portions of the No Surprise Act artificially deflate the qualifying payment amount. The group alleged the provisions of the rule “skew negotiations in favor of health insurers so strongly that health insurers will force physicians out of insurance networks and physicians will face significant practice viability challenges, struggling to keep their doors open in the wake of the pandemic.”
In his Aug. 24 ruling, U.S. District Judge Jeremy Kernolde — who has overseen all four lawsuits filed by the TMA — disallowed several provisions related to the QPA. According to the American Hospital Association, which filed an amicus brief supporting the TMA’s argument, those disallowments include those that could allow insurers to include the calculation of QPAs contracted rates for services that providers have not provided, as well as allowing self-insured group health plans to use rates from all plans administered by a third-party administrator in calculating the QPA, Becker’s reports. Read more.
