Federal court tosses neurosurgery practice’s NSA lawsuit 

A federal district court dismissed a lawsuit on May 23 filed by Neurological Surgery Practice of Long Island (N.Y.), ruling that HHS met its legal obligation under the No Surprises Act by creating a method for selecting independent dispute resolution entities, Vital Law reported May 30. 

What happened?

  • NSPLI, an out-of-network neurosurgery group, claimed health plans game the IDR selection timeline to push arbitrators that favor payers and delay reimbursement. The court found this didn’t amount to a legal failure by HHS.
  • While the court agreed NSPLI had standing to sue, it ruled that it lacked the power to force HHS to change its IDR procedures.
  • The court did recognize that NSPLI suffered real harm, including delayed payments and consistently being assigned arbitrators seen as payer-friendly.
  • It also found NSPLI’s injuries were linked to HHS regulations that allow payers to propose IDR entities late in the process, limiting providers’ ability to object.
  • The court said the case was ready for review and rejected HHS’s argument to wait for a pending rule change. But it stressed that the law only requires HHS to create an IDR selection method — not to meet specific standards or timelines.

What’s next?

  • The court dismissed the case with prejudice and said NSPLI’s best option is to pursue changes through the federal rulemaking process, not the courts.

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