Interventional Pain Management v. Horizon Blue Cross Blue Shield of New Jersey

Summary

The United States District Court for the District of New Jersey considers Horizon Blue Cross Blue Shield of New Jersey’s motion to dismiss a complaint seeking enforcement of Independent Dispute Resolution determinations under the No Surprises Act. The court holds that the statutory IDR process is not an arbitration subject to confirmation under Section 9 of the Federal Arbitration Act and that the No Surprises Act does not create an implied private right to judicial enforcement of IDR awards. The motion to dismiss is granted, and the plaintiff’s cross-motion to confirm the awards is denied.

Holdings

1. The statutory IDR process is not an arbitration eligible for confirmation under Section 9 of the Federal Arbitration Act because the parties had no written agreement to arbitrate and were compelled by statute to participate.
2. The No Surprises Act creates neither an express nor an implied private cause of action for judicial confirmation or enforcement of IDR determinations, and it limits judicial review to the specified FAA Section 10(a) vacatur circumstances.
3. Defendant did not waive its challenge by failing to petition to vacate the IDR determinations because it challenged Plaintiff's method of enforcement rather than the validity of the determinations.

Questions Presented

1. Whether independent dispute resolution determinations issued under the No Surprises Act qualify as arbitration awards eligible for confirmation under Section 9 of the Federal Arbitration Act.
2. Whether the No Surprises Act creates an express or implied private cause of action permitting a provider to obtain judicial confirmation or enforcement of an IDR determination.
3. Whether Defendant waived its dismissal argument by failing to petition to vacate the IDR determinations.

Disposition

dismissed