Health Affairs  |  December 19, 2022

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On November 30, 2022, the Texas Medical Association (TMA), joined by Dr. Adam Corley and the Tyler Regional Hospital, sued the Biden administration (for the third time) with respect to the implementation of the No Surprises Act (NSA). This lawsuit concerns the methodology for the qualifying payment amount (QPA), the insurer or plan’s median in-network rate. The QPA is the basis for determining individual cost sharing for items and services covered by the NSA’s balance-billing protections and also central to the independent dispute resolution (IDR) process.

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