Hartford Business Journal

HARTFORDBUSINESS.COM | OCTOBER 6, 2025 17 Image created by ChatGPT Arbitration Fight CT care providers, insurers square off in lawsuits tied to federal surprise-billing law behalf of Shareef Jandali Plastic Surgery in Trumbull; four are on behalf of DIEP Group CT, a recon- structive surgery practice in Trumbull; and two each are filed on behalf of New England PA LLC, a plastic surgery provider based in Old Lyme; Northeast Plastic Surgery Center in Old Lyme; and Plastic & Reconstruc- tive Surgery Group in Greenwich. Most of the lawsuits arise from procedures performed by doctors who were outside a patient's insur- ance network. In several instances, insurers declined to pay anything after receiving the bills. Under the No Surprises Act, both sides must first attempt to resolve such disputes during a 30-day negotiation window. When no agreement is reached, the case moves into the law's independent arbitration process. Merin, in a statement to the Hartford Business Journal, said By David Krechevsky davidk@hartfordbusiness.com A flurry of lawsuits filed in a Connecticut federal court since late July highlight the growing frustration among local medical providers with some of the nation's largest health insurers. Since July 23, at least 20 lawsuits have been filed in U.S. District Court in New Haven on behalf of five Connecticut-based providers — all of them plastic surgery or reconstruc- tive surgery groups represented by the same law firm. The lawsuits seek to force four insurers — Aetna, Anthem, Cigna and UnitedHealthcare — to pay arbitra- tion awards, some of which were imposed more than a year ago. The cases stem from disputes over how much insurers owe the providers for out-of-network care, and are a direct result of the federal No Surprises Act, which was approved in 2020 and took effect in 2022. The law is designed to protect patients from unexpected medical bills, and it created an independent dispute resolution process to settle payment fights between insurers and providers. While the law has lowered patients' out-of-pocket costs — one recent study found annual spending has fallen by nearly $600 per patient — providers say insurers are refusing to honor arbitration rulings. That has prompted doctors to ask courts to confirm the decisions and order payment. The new cases in Connecticut mirror a national surge in arbi- tration disputes. Providers argue insurers are dragging their feet on payments, while insurers say some arbitration decisions are flawed or overly generous. Judges in Connecticut have yet to rule on the latest batch of cases. But their decisions could determine how aggressively local courts enforce the process — and whether more providers pile on lawsuits to collect what they say they are owed. Meanwhile, conflicting federal court rulings have muddied the No Surprises Act's enforcement. A federal court in Connecticut has ruled that doctors may sue insurers directly to enforce arbitra- tion awards. But a Texas federal court — in a decision later upheld by the U.S. Court of Appeals for the Fifth Circuit in New Orleans — concluded that enforcement rests solely with the U.S. Department of Health and Human Services, not with providers themselves. The issue could end up in the Supreme Court, legal experts said. CT suits The 20 lawsuits in Connecticut were submitted on behalf of the five providers by attorney Clifford A. Merin of Merin Law in New Haven. Of the lawsuits he filed, 10 are on Continued on next page

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