Federal Courts Divided Over Private Enforcement of ‘No Surprises Act’ Arbitration Awards
Congress enacted the No Surprises Act ( NSA ) to protect patients from unexpected medical bills . A central pillar of the NSA is its independent dispute resolution ( IDR ) process, under which payers and providers can submit disputed claims to binding arbitration. Since the IDR process under the NSA began in April 2022, hundreds of thousands of claims have been submitted. As arbitrators have handed down awards, largely in favor of providers, a critical question has emerged — are these final and binding judgments privately enforceable? Two recent federal decisions, one from the District of Connecticut and one from the Fifth Circuit, have reached opposite conclusions. Guardian Flight LLC v. Aetna Life Ins. Co. , No. 3:24-cv-680-MPS (D. Conn. May 14, 2025): Private Right of Action Exists In Guardian Flight LLC v. Aetna Life Insurance Co ., the District of Connecticut addressed whether air ambulance providers could bring suit in court to enforce unpaid or late-...