Becker’s Healthcare Podcast Navigating the No Surprises Act and the Texas Medical Association Appeal
Nov 14, 2025
In this discussion, Patrick Velliky, Chief External Affairs Officer at HaloMD and a health policy expert, dives into the complexities of the No Surprises Act and its implications for hospitals. He highlights how the Texas Medical Association's lawsuits have influenced its implementation. Velliky sheds light on underutilized arbitration opportunities hospitals have under IDR, the financial pressures they face, and strategies for compliance. He emphasizes the need for proactive planning and staying updated on regulatory changes to secure fair payment rates.
AI Snips
Chapters
Transcript
Episode notes
TMA Litigation Altered NSA Implementation
- The Texas Medical Association's legal challenges forced implementation of the No Surprises Act closer to congressional intent.
- Many hospitals have underused arbitration opportunities due to narrow views of eligibility.
Actively Use IDR For Eligible Claims
- Evaluate whether more of your hospital claims qualify for independent dispute resolution (IDR).
- Pursue arbitration when appropriate to recover revenue and achieve fair reimbursement.
QPA Is One Factor Among Many
- The QPA is only one factor in arbitration and no longer dictates outcomes.
- Providers now win a large share of IDR cases by presenting other compelling considerations.