Mitchell F. Reiter MD PC v. Horizon Blue Cross Blue Shield of New Jersey

Summary

The United States District Court for the District of New Jersey dismissed an out-of-network provider’s claims seeking confirmation and enforcement of No Surprises Act independent dispute resolution awards. The court held that the No Surprises Act does not create a private cause of action to enforce such awards under section 9 of the Federal Arbitration Act and limits judicial review to the grounds identified in section 10(a) of the FAA. The court granted Horizon’s motion to dismiss and denied the provider’s cross-motions to confirm the awards and to stay discovery.

Holdings

1. The No Surprises Act does not authorize a private right of action to seek judicial enforcement or confirmation of an IDR award under section 9 of the Federal Arbitration Act.
2. FAA section 9 does not provide a basis for confirming the IDR awards because section 9 presupposes an agreement or contract to arbitrate and the complaint alleged no agreement between the provider and Horizon.
3. The NSA does not preclude enforcement under state law, even though it does not authorize a federal private action to confirm or enforce an IDR award.

Questions Presented

1. Whether the No Surprises Act creates or authorizes a private cause of action to enforce or confirm an independent dispute resolution award under section 9 of the Federal Arbitration Act.
2. Whether section 9 of the Federal Arbitration Act applies to a No Surprises Act IDR award when the parties had no agreement or contract to arbitrate.
3. Whether the plaintiff's claims should be dismissed under Federal Rule of Civil Procedure 12(b)(6).

Disposition

dismissed