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Last week, a federal court ruled on the mediation process created to settle out-of-network payment disputes. The ruling fell in favor of the Texas Medical Association and took issue with select portions of surprise billing regulations related to the arbitration process. Specifically, the independent dispute resolution process will no longer give increased weight to rates from insurers and providers contracted with in the past. The ruling does not strike down any of the patient protections included in the No Surprises Act.