District Court Finds NSA Final Rules Unlawful Again

The U.S. District Court for the Eastern District of Texas has ruled that the revised No Surprises Act ("NSA") Final Rules again tilt the IDR process in favor of the QPA. The Court concluded that the challenged portions of the Final Rule are unlawful and must be set aside under the Administrative Procedure Act.

The government has not yet made any comments regarding the Court's ruling as it is likely they are reviewing the Court's decision and considering next steps. The government may try to appeal the decision. Another step the government may take is to direct the certified IDR entities to comply with the Court's order, revise the Final Rules to align with the Court's judgment, and/or make revisions and updates to guidance documents to conform with the Court's order.

The Court's order did not affect any other provisions of the NSA which means that patients will continue to be protected from surprise bills for services covered under the NSA.

The opinion can be viewed at: https://law.justia.com/cases/federal/district-courts/texas/txedce/6:2022cv00372/217452/99/

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H.H.C. Group provides containment solutions for Insurers, Third Party Administrators, Self-Insured Employee Health Plans, Health Maintenance Organizations (HMOs), ERISA and Government Health Plans. H.H.C. Group utilizes a combination of highly skilled professionals and advanced information technology tools to consistently deliver targeted solutions, significant savings and exceptional client service.

H.H.C. Group's services include Claim Negotiation, Claim Repricing, Medicare Based Pricing, DRG Validation, Medical Bill Review (Audit), Claims Editing, Specialty Drug Cost Containment, Medical Peer Reviews/Independent Reviews, Independent Medical Examinations (IME), and Pharmacy Consulting. H.H.C. Group is an URAC accredited Independent Review Organization for Internal and External Reviews.

For additional information about H.H.C. Group and cost containment services, please visit www.hhcgroup.com or contact Bob Serber at rserber@hhcgroup.com or 301-963-0762 ext. 163#.