Can a provider sue for an unpaid IDR award in the Fifth Circuit?
Verdict Consulting Group Research · Updated
Answer
No, not under the No Surprises Act itself. In Guardian Flight v. Health Care Service Corp. (June 12, 2025), the Fifth Circuit held the Act contains no private right of action to enforce an IDR award, and the Supreme Court denied certiorari on January 12, 2026. The court also rejected the providers' derivative ERISA and Texas quantum meruit claims.
Detail
The decision
| Item | Detail |
|---|---|
| Case | Guardian Flight, L.L.C. v. Health Care Service Corp., 140 F.4th 271 |
| Court | U.S. Court of Appeals for the Fifth Circuit, No. 24-10561 |
| Decided | June 12, 2025; rehearing denied July 10, 2025 |
| Lower court | N.D. Tex. No. 3:23-cv-1861 |
| Holding | The No Surprises Act does not contain a private right of action to enforce IDR awards |
| Supreme Court | Certiorari denied January 12, 2026 (No. 25-441) |
The Fifth Circuit covers Texas, Louisiana and Mississippi. Other courts are divided; the Second Circuit reached the same conclusion on September 17, 2026, while the District of Maryland found a narrow implied right. See Can a provider sue to enforce an IDR award?.
Read the analysis
Sources
- U.S. Court of Appeals for the Fifth Circuit — Guardian Flight, L.L.C. v. Health Care Service Corp., No. 24-10561 (5th Cir. June 12, 2025) ()
- Supreme Court of the United States — Docket No. 25-441, Guardian Flight, L.L.C. v. Health Care Service Corporation ()
General information only, not legal advice. Verdict Consulting Group is not a law firm.