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Providers notch No Surprises Act legal win that could boost their pay

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Appeals court strikes down No Surprises Act payment calculation method

The 5th Circuit Court of Appeals ruled that insurers cannot include ghost rates or exclude bonus payments when calculating the qualifying payment amount used to determine reimbursement for out-of-network bills, a major win for healthcare providers that could increase their payments.

Aug 12, 2026·3 sourcesUS healthcare regulation5th Circuit Court of AppealsMedical billingPublic healthcare
Appeals court strikes down No Surprises Act payment calculation method
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Other sources for this story

Healthcare Dive

5th Circuit strikes down No Surprises billing benchmark in win for providers

MedCity News

Appeals Court Sides with Providers in No Surprises Act Pay Dispute