The Fifth Circuit Court of Appeals has handed down a significant decision in response to a challenge from health care providers to the implementing regulations of the No Surprises Act (“NSA”). The Court upheld the Departments of Treasury, Labor, and Health and Human Services’ (the “Departments”) approach to certain key
D. Austin Rettew
Austin Rettew is an associate in the Corporate and Litigation Departments and a member of the Health Care Group at Proskauer. His practice focuses on regulatory litigation and compliance within the health care sector. He provides strategic counsel to health care providers on managed care and commercial payer disputes, offering comprehensive regulatory, compliance, and reimbursement guidance to a diverse client base, including hospital systems, dialysis providers, anesthesia associations, physician practices, post-acute care service providers, and healthcare technology and revenue cycle management companies.
Austin is experienced in regulatory litigation and routinely advises clients operating within the complex landscape of the heavily regulated health care industry. His work in this area addresses compliance issues related to ERISA, the Affordable Care Act, the Medicare Secondary Payer Act, the Medicare Advantage program, the federal No Surprises Act, state surprise billing laws, state insurance laws, and the Mental Health Parity and Addiction Equity Act. He has represented providers, pharmaceutical manufacturers, and other health care companies in government investigations involving the Anti-Kickback Statute, the False Claims Act, and qui tam “whistleblower” lawsuits, working closely with company executives and consultants to develop effective compliance regimes while minimizing business disruption.
Austin also advises investors, owners, operators, and developers of long-term care and senior housing communities on health care transactions, regulatory compliance, corporate due diligence, and change of ownership procedures for state licensure, certificate of need, and Medicare and Medicaid certifications. He also drafts industry-specific comment letters for proposed regulations, ensuring that client perspectives and concerns are clearly communicated to regulatory bodies.
While in law school, Austin was an articles editor of the George Washington University Law School’s Public Contract Law Journal. Austin also served as a judicial intern for Judge Elizabeth S. Stong of the U.S. Bankruptcy Court for the Eastern District of New York and Magistrate Judge Lois Bloom of the U.S. District Court for the Eastern District of New York.
Prior to joining Proskauer, Austin was an associate in the Complex Litigation group at ArentFox Schiff.
Relator, No More? Florida Federal Court Declares Qui Tam Provisions of False Claims Act Unconstitutional, with Potentially Broad Implications for Government Fraud Litigation
On September 30, 2024, the U.S. District Court for the Middle District of Florida issued an order dismissing a qui tam case under the False Claims Act (“FCA”) and holding the relator provisions of the FCA to be unconstitutional.[1] In reaching this conclusion, the Court reasoned that the…
Post‑Chevron Spotlight: Disproportionate Share Hospital Payments Restored as Texas Hospitals Prevail in Challenge to HHS Exclusion Rule
In a victory for Texas health care providers, in Baylor All Saints Medical Center dba Baylor Scott & White All Saints Medical Center‑Fort Worth et al. v. Xavier Becerra, case number 4:24‑cv‑00432, the United States District Court for the Northern District of Texas (“District Court”) has vacated a regulation…
No Surprises Here! Fifth Circuit Upholds Health Care Provider Challenge to No Surprises Act Regulations
In a recent win for health care providers, the United States Court of Appeals for the Fifth Circuit has affirmed a lower court’s decision to vacate key portions of regulations issued by the U.S. Departments of Treasury, Labor, and Health and Human Services (collectively, the “Departments”) under the No Surprises…
No Surprises Here! CMS Audit Uncovers Non-Compliance by Aetna in Calculation and Disclosure Requirements Under the No Surprises Act
In a recent audit, the Centers for Medicare & Medicaid Services (“CMS”) uncovered non-compliance by Aetna Health Inc. of Texas (“Aetna”) in calculating key payment information for air ambulance services under the No Surprises Act (“NSA”). These audit results highlight the ongoing challenges faced by providers and payors in…
No Surprises Here! Divergent Court Rulings Spotlight Ongoing Challenges in No Surprises Act Implementation; Tee Up Split in Authority on Award Enforcement Mechanisms
Two District Courts have reached opposite conclusions on the enforceability of arbitration awards under the No Surprises Act (“NSA”). The two decisions, while far from the final word on the subject, highlight the most recent challenge relating to the implementation of the NSA.
Enacted by Congress in 2020, the NSA…