Guardian Flight v. Health Care Serv.

In Guardian Flight, L.L.C. v. Health Care Serv. Corp., 140 F.4th 271 (5th Cir. 2025), the Fifth Circuit held that the No Surprises Act (NSA) reveals no intent by Congress to provide a private right of action to enforce an IDR award. To the contrary, the court held, the statute points in the opposite direction: it expressly bars judicial review except in the situations described in § 10(a) of the FAA. See id. at 275.

Section 10(a) deals with grounds for vacating an arbitral award. It says nothing about enforcement, which is addressed in § 9 of the FAA. Id. But the NSA does not incorporate § 9. Expressly referencing § 10 while omitting any reference to § 9 shows an intent to exclude the application of § 9. See id. at 277. Further, while omitting any provision for private confirmation or enforcement, Congress empowered the Department of Health and Human Services to assess penalties for failure to comply with the NSA. Id. The structure of the statute thus reveals an intent to enforce the NSA through administrative measures rather than private lawsuits, according to the Fifth Circuit.

This is the only Court of Appeals decision on this issue as of January 2026.

See also Worldwide Aircraft Servs. v. United Healthcare, No. 8:24-cv-2527-TPB-LSG, 2025 U.S. Dist. LEXIS 233132, at *3-4 (M.D. Fla. Nov. 28, 2025)