Biden Administration Pauses Surprise Billing Arbitration After Latest Legal Setback

February 17

The Biden administration suspended arbitrations related to the No Surprises Act (NSA), the law that banned medical balance billing in most cases, following Feb. 6 ruling from a Texas federal district court judge that struck down Biden administration regulations. The system was in stormy waters before the ruling, with federal officials already navigating a higher volume of arbitrations than expected and a national, coordinated wave of lawsuits brought by providers. Experts tell AIS Health, a division of MMIT, that the administration will need to be careful if it hopes to avoid providers’ legal ire while navigating a third attempt to write regulations governing the arbitration process, known as Independent Dispute Resolution (IDR), and a possible appeal of the new decision.

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Health Plan Weekly

Peter Johnson

Peter has worked as a journalist since 2011 and has covered health care since 2020. At AIS Health, Peter covers trends in finance, business and policy that affect the health insurance and pharma sectors. For Health Plan Weekly, he covers all aspects of the U.S. health insurance sector, including employer-sponsored insurance, Medicaid managed care, Medicare Advantage and the Affordable Care Act individual marketplaces. In Radar on Drug Benefits, Peter covers the operations of (and conflicts between) pharmacy benefit managers and pharmaceutical manufacturers, with a particular focus on pricing dynamics and market access. Before joining AIS Health, Peter covered transportation, public safety and local government for various outlets in Seattle, his hometown and current place of residence. He graduated with a B.A. from Colby College.