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Fifth Circuit ruling in Texas Medical Association case reshapes No Surprises Act payment benchmark for Nutex

Fifth Circuit ruling in Texas Medical Association case reshapes No Surprises Act payment benchmark for Nutex

ReutersReuters2026/08/13 20:03
  • Fifth Circuit, sitting en banc, vacated key parts of the July 2021 rule underpinning No Surprises Act payment benchmarks.
  • Ruling bars insurers from using “ghost rates” in Qualifying Payment Amount calculations for out-of-network reimbursement disputes.
  • Insurers must include bonus and incentive payments in QPAs, reversing an approach the court said artificially deflated benchmarks.
  • Providers such as Nutex negotiate rates around QPAs, with unresolved cases moving to independent dispute resolution arbitration.
  • Court directed agencies to allow continued use of existing QPAs until new rules reset calculations consistent with the statute.


Disclaimer: This news brief was created by Public Technologies (PUBT) using generative artificial intelligence. While PUBT strives to provide accurate and timely information, this AI-generated content is for informational purposes only and should not be interpreted as financial, investment, or legal advice. Nutex Health Inc. published the original content used to generate this news brief via EDGAR, the Electronic Data Gathering, Analysis, and Retrieval system operated by the U.S. Securities and Exchange Commission (Ref. ID: 0001628280-26-056696), on August 13, 2026, and is solely responsible for the information contained therein.

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