A federal judge in the U.S. District Court for the Middle District of Florida has dismissed a lawsuit brought by Aetna against radiology providers, marking a notable development in disputes tied to the No Surprises Act. The case centered on allegations that Radiology Partners and Mori, Bean and Brooks leveraged the law’s independent dispute resolution (IDR) process to secure higher reimbursements on out-of-network claims.
According to court filings, Aetna argued that tens of thousands of disputes were submitted through arbitration, resulting in significantly higher payouts—including examples where routine services saw large increases after IDR decisions. The insurer also alleged that some claims were inaccurately characterized as out-of-network to qualify for arbitration.
However, the court ruled that Aetna’s arguments did not meet the threshold required to overturn arbitration outcomes under the Federal Arbitration Act. The judge emphasized that Aetna had prior awareness of the billing practices and failed to challenge them during the arbitration process itself.
For healthcare organizations, the decision reinforces the strength and finality of the IDR process under the No Surprises Act, while underscoring the importance of addressing disputes during arbitration rather than pursuing challenges afterward.
Resource: Court dismisses Aetna suit against radiology group