The American Society of Anesthesiologists filed an amicus brief this week in the U.S. District Court for the Eastern District of Pennsylvania supporting NorthStar Anesthesia in a lawsuit brought by UnitedHealthcare over the independent dispute resolution process under the No Surprises Act.
According to a March 19 news release, ASA said in the filing that the court should dismiss UnitedHealthcare’s fraud claims, arguing that disputes over IDR eligibility are legal determinations and not grounds for fraud litigation.
The group said eligibility decisions are complex and frequently disputed, and that confusion or errors in determining eligibility are common and do not constitute fraud. ASA added that certified IDR entities use independent judgment and do not rely on either party’s legal assertions when making determinations.
ASA also cited operational challenges for anesthesiologists, who often must rely on incomplete information from insurers when assessing IDR eligibility. The organization has called on federal regulators to require insurers to provide clearer and more complete data.
The brief also pointed to an existing administrative process through the CMS that allows IDR decisions to be reopened when errors are identified, which ASA said should be used instead of fraud litigation.
