Resources
Practical Guidance for Self-Funded Health Plans.
White papers, court decisions, and legislation for employers, TPAs, brokers, and cost containment partners navigating medical billing disputes, NSA compliance, and reference-based pricing.
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Balance Billing
NSA / IDR
Reference-Based Pricing
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All Topics
Balance Billing
NSA / IDR
Reference-Based Pricing
ERISA
Cost Containment
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White Paper
NSA / IDR
NSA / IDR
How Private-Equity Emergency Providers Are Using IDR Against Health Plans
A small number of PE-owned emergency groups are responsible for a disproportionate share of IDR filings. What plan sponsors need to know about the pattern and how to defend against it.
Published June 2026 · PDF, 14 pages
White Paper
Reference-Based Pricing
Reference-Based Pricing
Reference-Based Pricing and the No Surprises Act: How RBP Plans Should Structure Their IDR Defense
How RBP payment logic interacts with NSA IDR rules and what plans need to do to reduce arbitration exposure while preserving the savings RBP delivers.
Published January 2026 · PDF, 11 pages
Court Decision
ERISA
ERISA
Rutledge v. Pharmaceutical Care Management Association — Implications for Self-Funded Plans
Analysis of the Supreme Court decision and what it means for state regulation of self-funded health plan benefit structures.
Published April 2026 · PDF, 8 pages
Legislation
NSA / IDR
NSA / IDR
No Surprises Act Final Rules: A Plain-Language Summary for Plan Sponsors
What the final NSA rules require of self-funded health plans, what changed from the interim rules, and what plan sponsors need to have in place now.
Published February 2026 · PDF, 18 pages
Court Decision
Balance Billing
Balance Billing
Texas Medical Association v. HHS: What the IDR Ruling Means for Health Plans
A breakdown of the TMA court decisions that reshaped the NSA IDR process and what health plans need to understand about their current obligations.
Published December 2025 · PDF, 12 pages
White Paper
ERISA
Balance Billing
ERISA
Balance Billing
Plan Sponsor Fiduciary Obligations in Medical Billing Disputes: A Practical Guide
What ERISA requires of plan sponsors when billing disputes arise, what documentation is necessary, and how active advocacy supports fiduciary compliance.
Published November 2025 · PDF, 9 pages
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aequum LLC is not a law firm. Legal services are provided by Koehler Fitzgerald LLC. Results vary. No attorney can guarantee a particular outcome.
aequum LLC is not a law firm. Legal services are provided by Koehler Fitzgerald LLC. Results vary. No attorney can guarantee a particular outcome.