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Elevance subsidiary No Surprises Act lawsuit dismissed

Susan Morse
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⚡ Quantum Brief
A federal judge in California dismissed a lawsuit by Elevance Health’s Anthem Blue Cross against HaloMD and three healthcare providers over alleged fraud in the No Surprises Act’s arbitration process. Anthem accused HaloMD, owned by LaRoque Family Providers, of exploiting the Independent Dispute Resolution system to secure inflated reimbursements through mail and wire fraud. Judge Karen Scott ruled Anthem failed to provide sufficient evidence of misuse, rejecting claims that HaloMD manipulated the system for excessive payouts. HaloMD faces similar lawsuits from four Blue Cross Blue Shield insurers, all alleging it rigged the arbitration process to benefit providers and itself. The LaRoques, HaloMD’s founders, deny wrongdoing, despite reports they profited significantly from the No Surprises Act’s dispute resolution framework.
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Quantum News · Media Library

Elevance subsidiary No Surprises Act lawsuit dismissed The complaint alleged corruption by HaloMD, a company that handles the arbitration process for medical billing disputes. Compliance & Legal By Susan Morse , Executive Editor | April 15, 2026 | 10:48 AM Photo: Costella/Getty Images A judge has dismissed a lawsuit brought by an Elevance subsidiary over the No Surprises Act Independent Dispute Resolution process.A federal judge in California dismissed the lawsuit by Elevance Health subsidiary Anthem Blue Cross Life and Health Insurance Co. against billing dispute consultant HaloMD and provider plaintiffs MPOWERHealth Practice Management, Bruin Neurophysiology and Sound Physicians Emergency Medicine of Southern California. HaloMD administers independent dispute resolution (IDR) proceedings on behalf of healthcare providers.Anthem accused HaloMD of obtaining inflated reimbursements through the No Surprises Act's IDR system.In the civil lawsuit brought in July 2025, Anthem alleges violations by the LaRoque Family Providers, owner of HaloMD. It made accusations of mail and wire fraud in submitting ineligible billing disputes to the IDR process.According to Anthem, "Plaintiffs allege that Defendants use three 'tactics' to turn the NSA's IDR process 'into a vehicle for fraud.'"Anthem said it was seeking judicial review of Defendants' NSA schemes, and not any individual IDR payment determination.Judge Karen Scott dismissed the suit, ruling that Anthem Blue Cross did not show sufficient evidence of misuse of the IDR system by HaloMD or the other defendants.HaloMD is fighting lawsuits from four different Blue Cross Blue Shield insurers accusing it of rigging the system and triggering huge payouts for itself and its provider clients, according to STAT. Alla and Scott LaRoque founded the LaRoque Family Providers and have profited off the No Surprises Act law, the report said. The LaRoques have denied the allegations, STAT said. Email the writer: [email protected] Topic: Accounting & Financial Management, Billing and Collections, Business Intelligence, Compliance & Legal

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