America's Health Insurance Plans says that the decision weakens patient protections and enables providers to profit off the arbitration process.
A federal judge on Wednesday agreed with the Texas Medical Association that the arbitration process in the No Surprises Act violates the Administrative Procedure Act.
Providers have taken issue with a portion of the process that assumes the qualifying payment amount, which is the median in-network rate set by health insurers, is the appropriate out-of-network rate, Becker's Hospital Review reported. The ruling leaves in place protections for patients against getting bills for thousands of dollars in situations such as going to the emergency room and later finding out one of the doctors was not covered by their insurance.
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