TEXAS MEDICAL ASSOCIATION and ADAM CORLEY, Plaintiffs, v. UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES, et al., Defendants., 587 F. Supp. 3d 528

Summary

HOLDINGS: [1]-Plaintiffs, a trade association and a physician, had standing to challenge an interim final rule issued pursuant to the No Surprises Act, 42 U.S.C.S.§§ 300gg-111, 300gg-131, 300gg-132, that governed the arbitration process for resolving payment disputes between certain out-of-network providers and group health plans and health insurance issuers because plaintiffs demonstrated two cognizable injuries resulting from the rule, and the association had standing to bring the action on behalf of its members, and further, the physician and association members had prudential standing; [2]-The rule had to be set aside under the APA because the Act unambiguously established the framework for deciding payment disputes and the rule conflicted with the statutory text, and because defendants improperly bypassed notice and comment required by the APA, 5 U.S.C.S. § 553.