AHA files amicus brief challenging district court decision rendering IDR awards unenforceable

The AHA filed an amicus brief Oct. 4 in the U.S. Court of Appeals for the 5th Circuit challenging a decision by the U.S. District Court for the Northern District of Texas, which ruled that independent dispute resolution awards under the No Surprises Act are judicially unenforceable. The AHA argued the district court's decision was inconsistent with longstanding interpretations of the law and would threaten serious harm to providers.

"[T]he district court interpreted the NSA to render entire sections of it nugatory," AHA wrote. "There is no need for an IDR process - or any of the NSA's other payment mechanisms - if nothing requires insurers to render payment upon an IDR determination." The district court's interpretation of the No Surprises Act "gives insurers significant leverage to demand confiscatory discounts from out-of-network providers, as well as to exact across-the-board rate cuts from in-network providers… Both in- and out-of-network providers will thus find themselves perpetually underpaid or even uncompensated for their valuable services, and patients will lose providers and critical care as a result," the brief notes.

The American Medical Association, Federation of American Hospitals and the Texas Medical Association joined AHA in the brief.