GUARDION MEDICAL LLC v. MEDCOST BENEFITS SERVICES

IN THE UNITED STATES DISTRICT COURT
FOR THE MIDDLE DISTRICT OF GEORGIA
MACON DIVISION
GUARDION MEDICAL, LLC, 	)
)
Plaintiff, 	)
)
v. 	) 	CIVIL ACTION NO. 5:25-cv-223 (MTT)
)
MEDCOST BENEFIT SERVICES, LLC,1 	)
)
Defendant. 	)
)
ORDER
Plaintiff, GuardION Medical, LLC, provides medically necessary services to
patients insured under health plans administered by Defendant, MedCost Benefit
Services, LLC.2 ECF 1 ¶ 11. Defendant underpaid Plaintiff for these services, so Plaintiff
sought relief via the administrative process set forth in the No Surprises Act, 42 U.S.C.
§ 300gg-111, for resolving such disputes. Id. ¶¶ 13–18. That process resulted in
Independent Dispute Resolution (“IDR”) awards issued against Defendant. Id. But
Defendant has not complied with the IDR awards’ payment obligations. Id. ¶¶ 19, 20.
Consequently, Plaintiff petitions the Court to confirm the IDR awards under the Federal
Arbitration Act (“FAA”), 9 U.S.C. § 9. Id. ¶¶ 21–25; ECF 3. Defendant moves to dismiss,
arguing the No Surprises Act does not confer a private right of action to confirm an IDR
award under the FAA. ECF 11; ECF 12 at 5–9.
1 The complaint identifies Defendant as “Medcost Benefits Services” rather than “MedCost Benefit
Services, LLC.” Compare ECF 1 with ECF 11.
2 At the motion to dismiss stage, “all well-pleaded facts are accepted as true, and the reasonable
inferences therefrom are construed in the light most favorable to the plaintiff.” FindWhat Inv. Grp. v.
FindWhat.com., 658 F.3d 1282, 1296 (11th Cir. 2011) (quoting Garfield v. NDC Health Corp., 466 F.3d
1255, 1261 (11th Cir. 2006))
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This Court is not the first to address the question, and the majority of courts to
have done so have held the No Surprises Act does not confer a private right of action to
confirm an IDR award under the FAA. See e.g., East Coast Advanced Plastic Surgery,
LLC v. Cigna Health and Life Insurance Co., 2025 WL 2371537, at *17 (S.D.N.Y. Aug.
14, 2025) (collecting cases). In addition to East Coast Advanced Plastic Surgery, 2025
WL 2371537, at *17, the Court finds particularly persuasive the decisions by the United
States Court of Appeals for the Fifth Circuit, Guardian Flight, L.L.C. v. Health Care Serv.
Corp., 140 F.4th 271, 275–77 (5th Cir. 2025), cert. denied, 2026 WL 79855 (U.S. Jan.
12, 2026), and by the United States District Court of the District of New Jersey, Modern
Orthopaedics of NJ v. Premera Blue Cross, 2025 WL 3063648, at *9–14 (D.N.J. Nov. 3,
2025). For the reasons stated in those decisions, the Court concludes there is no
private right of action under the No Surprises Act to enforce IDR awards.3
Nor does the FAA independently confer jurisdiction to enforce the IDR awards
here. “[A]rbitration, at least under the FAA assumes an agreement or contract to
arbitrate.” See Med-Trans Corp. v. Cap. Health Plan, Inc., 700 F. Supp. 3d 1076, 1083
(M.D. Fla. 2023) (citation modified), aff'd sub nom. Reach Air Med. Servs. LLC v. Kaiser
Found. Health Plan Inc., 160 F.4th 1110 (11th Cir. 2025). Plaintiff does not allege, nor
does it argue, that it reached an agreement to arbitrate with Defendant. See ECF 1, 14.
Plaintiff argues equitable principles such as unjust enrichment and restitution
provide a viable remedy even if there is no private right of action to enforce an IDR
award under the No Surprises Act. ECF 14 at 17–19. But Plaintiff’s complaint nowhere
3 Defendant also argues the IDR process does not apply to third-party administrators like Defendant. ECF
12 at 9–11. The Court does not reach Defendant’s second argument for dismissal because the Court
agrees it lacks jurisdiction to enforce an IDR award.
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mentions unjust enrichment or restitution, and Plaintiff has not properly requested leave
to amend the complaint. ECF 1; ECF 14 at 16–19; see Newton v. Duke Energy Fla.,
LLC, 895 F.3d 1270, 1277 (11th Cir. 2018) (“[w]here a request for leave to file an
amended complaint simply is imbedded within an opposition memorandum, the issue
has not been raised properly.” (quoting Rosenberg v. Gould, 554 F.3d 962, 967 (11th
Cir. 2009))).4
Accordingly, the Defendant’s motion to dismiss (ECF 11) is GRANTED. Plaintiff’s
Petition to Confirm Arbitration Award (ECF 3) is DENIED. This case is DISMISSED
without prejudice for lack of subject matter jurisdiction.
SO ORDERED, this 27th day of January, 2026.
S/ Marc T. Treadwell
MARC T. TREADWELL, JUDGE
UNITED STATES DISTRICT COURT
4 Nor is it readily apparent how Plaintiff’s arguments concerning vacatur and modification under the FAA
have any bearing on Defendant’s argument that the Court lacks subject matter jurisdiction in this case.
See ECF 14 at 3–5. To be clear, the Court is not modifying or vacating Plaintiff’s IDR awards by
dismissing this case for lack of jurisdiction.
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