LifeNet, an air ambulance provider based in Texas that transports patients in Louisiana and Arkansas, filed suit to challenge the No Surprises Act, claiming the government treats air ambulance providers differently, still holding them to the guidance on arbitration that was struck down as to other providers, and that being held to presumptive qualifying payment amount of median in-network rate for arbitration is arbitrary and irrational.

The court agreed with the plaintiffs, ruling that it is unlawful to create a presumption that the qualifying payment amount applies absent clear evidence to the contrary.