The New York surgeon's bid against the No Surprises Act for being unconstitutional was tossed as the federal law was upheld.
A federal judge denied a New York doctor's lawsuit against the No Surprises Act, dismissing the request for a preliminary injunction and ruling that the law is constitutional.
U.S. District Judge Ann Donnelly rejected surgeon Daniel Haller's injunction to blow the law, which was filed on December 31, 2021, the day before the No Surprises Act took effect.
The surprise billing ban was put in place to protect patients from receiving unforeseen bills for out-of-network and emergency services after receiving treatment.
Haller and his private practice, which performs procedures on patients who are admitted after an emergency department visit, alleged in the complaint that the law is unconstitutional and deprives providers the right to be paid a reasonable payment for their services due to the independent dispute resolution process (IDR). The arbitration is meant to keep patients out of negotiations between providers and insurers as the parties attempt to reach agreement on the payment for services.
Related: Piece of Arbitration Process in No Surprises Act Struck Down in Federal Court
Haller claims that 78% of his patients are covered by health plans with which the practice has no contractual relationship, making the majority of his patients out-of-network.
However, Donnelly ruled that Haller and his practice's due process claim was "unripe" and did not carry jurisdiction.
"The plaintiffs do not allege that they have participated in an arbitration, much less that the IDR process resulted in a payment amount below the reasonable value. At the time of oral argument—almost six months after the Act went into effect—the plaintiffs could not say whether they had participated in the IDR process," Donnelly wrote in the ruling. "They do not allege that the IDR process has caused any concrete harm, so their claims of constitutional injury are speculative."
Jay Asser is the contributing editor for strategy at HealthLeaders.