A Florida federal district court has upheld an independent dispute resolution (IDR) award to an air ambulance provider under the No Surprises Act (NSA) that Congress enacted as part of the Consolidated Appropriations Act, 2021. The air ambulance provider transported a patient from the Dominican Republic to Florida. Thereafter, the provider sought reimbursement from a company licensed to cover travel health insurance and handle related claims outside the U.S. for a major U.S. health insurer. The provider failed to process its claim or use the company’s internal appeals process. As a result, the provider pursued IDR against the company and was awarded more than $200,000 by the certified IDR entity, although the company did not participate in the IDR process.
The air ambulance provider asked the court to uphold the IDR award, and the travel company asked the court to vacate the award. The case is Worldwide Aircraft Servs., Inc. v. Worldwide Ins. Servs., LLC, 2024 WL 4226799 (M.D. Fla. 2024).
The travel company argued that it was neither an insurer nor a group health plan subject to the NSA since it did not issue insurance policies. It characterized itself as a third-party administrator who handled claims and transmitted information to the appropriate healthcare insurer. The company argued that it had no payment or decision-making authority in this role.
However, the court disagreed, pointing out that the company’s website advertised travel and international health insurance and medical plans. The court noted that it also performed certain actions akin to an insurer, such as issuing claim numbers, paying providers, and acting as the sole party for the submission of claims.
Likewise, the court rejected the travel company’s argument that it did not receive proper notice of the IDR proceedings because the notice was sent to the wrong email address. The court found that the company’s failure to monitor email addresses made available to the public was not a sufficient argument for lack of notice in the IDR proceedings. Therefore, the court upheld the IDR award.
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