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[Ed Gaines @EdGainesIII]

Exhibit A for passage of the No Surprises Act Enforcement Act (H.R. 4710) is demonstrated by the experience of Radiology Associates of North Texas (RANT), one of the largest independent radiology groups in the US.

According to Radiology Business (5/20/2026), "Radiology Associates estimates it has prevailed in about 95% of finalized IDR disputes with Blue Cross Blue Shield of Texas, the state’s largest insurer. However, more than $3.5 million in awarded balances remain unpaid. RANT estimated that $1.64 million of this total has been outstanding for over 120 days. As of Tuesday, BCBS Texas has paid approximately 2% of awarded balances."

RANT is not alone in this experience.

The Emergency Dept. Practice Management Association (EDPMA), representing well over 60% of the ED groups providing care to ED patients (or organizations supporting the provision of care), released a study in April 2026 of over 659,000 successful NSA IDR claims won by its members in 2025. Yet, 48% of those IDR determinations were not paid within the 30-day period required by law. The total outstanding of award determinations not paid by the health plans exceeded $245,000,000.

Congress must pass HR 4710 to give CMS the same enforcement authority it has over hospitals and physicians that it does not currently have over health plans, mainly the ability to assess Civil Monetary Penalties (CMPs) for non-compliance with the NSA.

Radiology Associates of North Texas says it will waste over $51M on costs related to No Surprises Act https://t.co/VipNBtfaaG

[Alex Shteynshlyuger MD @DrAlexUrology]

Multiplan’s DNA is doublespeak, lie, and steal.

[Chris Palmer, MD @ChrisPalmerMD]

Evidence-based treatments for schizophrenia and bipolar disorder often lead to increases in LDL cholesterol.

We offer them to millions of patients anyway.

[Barstool Penn State @PSUBarstool]

WE GOING TO THE B1G CHIP

[Dutch Rojas @DutchRojas]

@TakeWeightOffMD @CastleConnolly @1ConciergeMed 🔥🔥🔥🔥🔥

[Dr Murphy WeightLoss @TakeWeightOffMD]

I am honored yet again to be nominated as a Top Doctor by @CastleConnolly @1ConciergeMed Thank you to my peers!

[Alex Meshkin, GED @alexmeshkin]

Nobody could have….

[Concierge Medical @1ConciergeMed]

@X get your censorship straight. How is that sensitive?

[Tengwall Film Network @tengwallTFN]

One of our channel’s Day 1 favorites

[Chris Buchignani @buchignani]

An Open Welcome Letter to @CoachMC_PSU

"Penn Staters aren’t born; they’re made. Bit by bit, it will start to seep in, and one day, you will wake up and discover that you are home."

READ: https://t.co/HockRMeAu7

[Bad Rad Brad @B1OBEY0ND]

@Tony_Rojas5 Congrats to Duke & Manny.
Manny Diaz just won the ACC.
Terry Smith won out at PSU.

Really makes you question Franklin & what he was actually doing.

[Tengwall Film Network @tengwallTFN]

The Blueprint.

[Tengwall Film Network @tengwallTFN]

THE OBLIGATORY PSU PREGAME SHOW

🔵Penn State⚪️ 🔴Indiana ⚪️

WAKE UP! IT'S GAMEDAY!

📺Link: https://t.co/m3lJvsRKoL

[Chris Buchignani @buchignani]

Aside from the obvious ways in which this thesis is flawed, if Pete ever tried to undercut his boss like JF apparently did this Summer, he’d likely learn a new definition of the term “patience” the following day.

You know what they say about when you come at the king…

[Liam Belan @lbelanMVI]

The bad news continues for Penn State football fans.

Following a 6 touchdown performance against a top Class 4A team in Mars, 5-star RB commit Kemon Spell confirms he's "not 100% with Penn State". He has a visit scheduled to Georgia after recently being offered.

@MVI_sports

[Tengwall Film Network @tengwallTFN]

Back leg dropped, poor technique

[Coach Codutti @coachcodutti]

Did I mention he’s a 60 foot shot putter too?

[Concierge Medical @1ConciergeMed]

@ChrisVannini They’ll lose to Pitt.

[Chris Vannini @ChrisVannini]

Notre Dame is 0-2 with two close losses.

Would 10-2 with this remaining schedule make the Playoff?

[DoctorTro @DoctorTro]

Go to church
Then go to the gym