Mandelbaum Barrett PC healthcare litigation team, led by Mohamed H. Nabulsi and Todd M. Nosher, Esqs., has been retained by Norman M. Rowe, M.D., Norman M. Rowe, M.D. PLLC, M. Rowe MD of New Jersey LLC, Rowe Plastic Surgery of New Jersey LLC and East Coast Plastic Surgery PLLC PA (collectively, the “Clients”) in connection with a federal civil action recently filed by EmblemHealth Inc. (“Emblem”). Emblem is seeking to unwind over 20 final arbitration awards against it arising from independent dispute resolution (“IDR”) proceedings held pursuant to and in strict accordance with statutory law under the federal No Surprises Act (“NSA”). The awards, dating back as far as 2024, were issued by qualified, neutral arbiters (Certified Independent Dispute Resolution Entities (“IDREs”), who carefully considered the parties’ positions and made their decisions based on specific factors mandated by law. Emblem—who fully participated in each disputed arbitration—never challenged the final awards before this Action.
But now, displeased with the entire IDR process, which seeks to even the playing field for providers, and threatens Emblem’s unwieldy leverage over healthcare providers and patients alike, Emblem has joined other large insurance companies who have waged an industry-wide, collateral attack on the IDR system itself. In doing so, Emblem and the other large insurers are seeking to relitigate final arbitration decisions against them—but apparently take no issue with the awards they won. Clearly, Emblem has no issue with the NSA or the IDR process to the extent it furthers its pecuniary interests.
Specifically, Emblem is trying to manufacture claims because certain providers exercised their lawful choice to initiate disputes through the IDR system to address unacceptably low payments by Emblem—and because neutral arbiters selected by the Parties or otherwise assigned by the Centers for Medicare & Medicaid Services ruled against it. But providers have every right to exercise their right to obtain an independent review by IDREs under the NSA and Emblem’s dissatisfaction with the process itself does not give rise to claims for fraud.
Fortunately, the courts are seeing this campaign for what it is and dismissing similar claims by other large insurance companies. See, e.g., Modern Anthem Blue Cross et al. v. HaloMD LLC, 8:25-cv-01467 (C.D. Cal. April 9, 2026); Aetna Health Inc. et al. v. Radiology Partners, Inc. et al., (M.D. Fla. April 20, 2026) (Dkt. No. 60-1). For example, in a decision issued just last week, a federal court in Florida made clear that the insurer’s “attempt to end-around the NSA and FAA strictures is preempted” and restated the tenet that “NSA adopts the ferocity of the FAA in defending arbitration awards.”
We are confident that our clients will be vindicated. As evidence of the weakness of its legal claims against our clients, Emblem has levied personal attacks against Dr. Rowe in an effort to sully his distinguished reputation and intimidate him from continuing to fight for his patients. These attacks will not go unanswered as Dr. Rowe will never waiver from protecting his and his practices’ reputation and the rights of his patients.
Mandelbaum Barrett is currently preparing its response to Emblem’s complaint in which it will seek a full dismissal with prejudice against Emblem and will pursue all appropriate defenses, claims and remedies to protect its Clients’ interests.
Due to the pending nature of the litigation, we will not comment further on specific allegations at this time.
View source version on businesswire.com: https://www.businesswire.com/news/home/20260430802636/en/
Contacts
Mohamed H. Nabulsi, Esq.
mnabulsi@mblawfirm.com
