Whether a breach of ERISA plan terms alone constitutes an injury in fact for plan beneficiaries

The No Surprises Act (“NSA”) is Congress’s solution to the problem of surprise medical bills . Under the NSA , insurer s must cover services provided by out -ofnetwork emergency healthcare provider s and pay provider s directly . Patients cannot be billed for any unpaid balance s. The NSA applies to both fully insured health plans and ERISA plans, meaning its coverage mandate is a benefit in every ERISA plan. The NSA channel s out-of-network provider -insurer payment disputes into an arbitrationlike independent dispute resolution process (“IDR”) . The NSA expressly provides that IDR awards are “binding” and dictates that the insurer “shall ” pay the provider any amounts owed within 30 days of an IDR determination . Petitioners are air -ambulance providers who transported patients covered by both traditional insurance and ERISA plans offered or administered by Respondent Health Care Service Corporation. The parties submitted their payment dispute s to IDR, and Petitioners were awarded additional reimbursement. But Respondent did not pay. The question s presented are: 1. Whether , in keeping with American courts’ traditional recognition that a breach of contract is in itself an actionable injury, a breach of ERISA p lan terms constitutes an injury in f act to a n ERISA plan beneficiary , even where the beneficiary will not suffer any pocketbook injury . 2. Whether , when Congress provided that NSA IDR awards are “binding” and mandated that insurers “shall ” pay them within 30 days, it intended to allow providers to sue in court to enforce the awards .