On September 8, 2025, a shareholder of Nutex Health, Inc. (“Nutex”) filed a derivative action in the Southern District of Texas that places the No Surprises Act (“NSA”) squarely at the center of a corporate-governance fight. Specifically, the complaint alleges that Nutex’s heavy reliance on the NSA’s independent dispute resolution
Healthcare
No Surprises Here! New York and Florida Courts Reject Provider Suits to Enforce NSA IDR Awards, Heightening Pressure for Appellate Review
In a pair of recent back-to-back rulings, Federal district courts in Florida and New York have held that the No Surprises Act (“NSA”) does not permit providers to bring private causes of action to enforce Independent Dispute Resolution (“IDR”) awards issued under the NSA. Following on the heels of earlier…
Proskauer Secures Landmark Settlement with New York State to Expand Access to Children’s Mental Health Services
By Michael Menconi on
[This blog post was originally published on Proskauer’s Social Responsibility and Pro Bono blog here.]
A Proskauer team, along with Disability Rights New York (DRNY), Children’s Rights (CR) and the National Health Law Program (NHeLP), reached a preliminary settlement agreement with the State of New York in C.K. v.
No Surprises Here! Payers Push Back on IDR Submissions, Opening New Front in NSA Implementation Landscape
On May 27, 2025, Blue Cross Blue Shield Healthcare Plan of Georgia (“BCBSGA”) sued several emergency physician groups and their billing agent, Halo MD, alleging abuse of the No Surprises Act’s (“NSA”) independent dispute resolution (“IDR”) process. The complaint claims the providers submitted ineligible claims, made false attestations, and inundated…
No Surprises Here! Fifth Circuit Holds NSA Provides No Private Right of Action to Enforce IDR Awards, Deepening Judicial Divide on Award Enforcement Mechanisms
In a recently issued opinion, the Fifth Circuit has added yet another chapter to the growing debate over whether providers may seek judicial enforcement of Independent Dispute Resolution (“IDR”) awards issued under the No Surprises Act (“NSA”). In a much-anticipated decision, the Fifth Circuit has held that the NSA does…
No Surprises Here! Connecticut District Court Confirms IDR Awards Are Enforceable Under the NSA, Deepening Judicial Divide Over Award Enforcement Mechanisms
By Vinay Kohli & D. Austin Rettew on
The U.S. District Court for the District of Connecticut has become the latest court to weigh in on whether Independent Dispute Resolution (“IDR”) awards issued under the No Surprises Act (“NSA”) are enforceable. In a recent decision, the District Court has held that providers may sue to enforce arbitration…
CMS to Immediately Begin Auditing Medicare Advantage Plans in Significant Expansion of Enforcement Efforts
On May 21, 2025, the Centers for Medicare and Medicaid Services (“CMS”) announced a significant expansion of its auditing efforts with respect to Medicare Advantage (“MA”) plans.
For newly initiated audits of MA plans, CMS will audit all eligible MA contracts for each payment year. Additionally, for audits already initiated…
Disproportionate Impact: Supreme Court Narrows Disproportionate Share Hospital Reimbursement to Supplemental Security Income Cash Recipients
The U.S. Supreme Court has issued a significant ruling affecting hospitals that serve low-income Medicare beneficiaries, narrowing the interpretation of the Disproportionate Share Hospital (“DSH”) payment formula. In Advocate Christ Medical Center v. Kennedy, the Court determined that only Medicare patients who were eligible to receive a cash Supplemental…
Post‑Chevron Spotlight: Federal Court Nixes FDA Rule Reclassifying Laboratory Services as Medical Devices
In another rebuke to federal regulatory overreach, the U.S. District Court for the Eastern District of Texas (“District Court”) has vacated the Food and Drug Administration’s (“FDA”) 2024 final rule that sought to bring laboratory‑developed test services (“LDTs”) within the scope of the agency’s medical device regulatory framework. The case…
DOH Issues Guidance on New York’s Material Health Care Transaction Law
Nearly two years ago, and as previously discussed in a Proskauer alert, New York enacted Public Health Law Article 45-A (the “Material Transactions Law”), which requires reporting of certain material health care transactions. Last month, the New York State (“NYS”) Department of Health (“DOH”) published long-awaited guidance concerning the…