Texas Medical Association et al v. U.S. Department of Health and Human Services (TMA I)Date Filed: October 28, 2021
District Court: U.S. District Court for the Eastern District of Texas – 6:21-cv- 00425
Appellate Court: Fifth Circuit (No. 22-40264)
Nature of Suit: Challenge of Regulatory Mandate (No Surprises Act)
Defendant Type: Federal
Plaintiff Type: Private
Court Document: https://www.texmed.org/uploadedFiles/Current/2016_Advocacy/Surprise_Billing_Lawsuit_102821.pdf,
The Texas Medical Association (TMA) filed a complaint against the U.S. Department of Health and Human Services, Department of Labor, Department of the Treasury, Office of Personnel Management, and the heads of those agencies in their official capacity. The suit challenged the Biden administration’s independent dispute resolution (IDR) process of the No Surprises Act as proposed by HHS in its interim final rule. TMA argued the IDR was an unfair process to resolve billing disputes between health insurers and providers because it was biased in favor of payors and that the rule was issued without proper the notice and comment period. The lawsuit is one of several similar suits filed by provider groups. The federal judge ruled for the TMA, granting summary judgment on February 23, 2022, and vacating the portions of the rule at issue instead of sending it back to the agencies to fix.
Defendants filed an appeal but then voluntarily dismissed it on October 24, 2022.