| Abstrakt: |
The recent decision by the 5th Circuit Court of Appeals allows insurers to use a wider range of rates in determining fair payment amounts in disputes over surprise medical bills. While this ruling is a rare win for federal regulators, it is a setback for providers who have been critical of the arbitration process set up by the No Surprises Act. The court's decision to include ghost rates, case-specific agreements, and bonus payments in the calculation of the qualifying payment amount (QPA) has implications for how disputes between providers and insurers are resolved. [Extracted from the article] |
