Federal Civil Update October 2024

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The following are summaries of selected civil opinions issued by the Fifth Circuit in August 2024. The summaries are overviews of particular aspects of the opinions; please review the entire opinions.

ADMINISTRATIVE LAW: Federal agency lacked statutory authority to promulgate decisional rules for insurance rate arbitrators.

Tex. Med. Ass’n v. U.S. Dep’t of Health & Hum. Servs., 110 F.4th 762 (5th Cir. 2024).

In its first comprehensive application of the Supreme Court’s Loper Bright decision, which overruled Chevron deference, the Fifth Circuit affirmed the district court’s vacatur of various insurance-rate regulations promulgated by Health & Human Services (HHS). 

The regulations concern insurance rate arbitration under the federal No Suprises Act (NSA). In relevant part, the NSA provides for arbitration if a patient’s insurer and his out-of-network provider cannot agree on a rate for provided services. The Act directs HHS to promulgate regulations establishing “one independent dispute resolution process…under which…[an arbitrator] determines…the amount of payment” for covered services “in accordance with” various statutory provisions.

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