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No Surprises Act Payments Resume

The Department of Health and Human Services (HHS) has published guidance on the federal independent dispute resolution (IDR) process for disputing parties, allowing all payments to resume.

HHS on Feb. 10 instructed federal IDR entities not to issue new payment determinations in payment disputes related to out-of-network billing made on or after Feb. 6, due to a court ruling vacating certain portions of the No Surprises Act related to the consideration of the qualifying payment amount.

On Feb. 27, HHS released guidance to allow IDR entities to resume issuing payment determinations for payment disputes involving out-of-network services furnished before Oct. 25, 2022.

This latest guidance allows all IDR payment determinations to resume. The guidance also notes disputing parties will receive the majority of their payment determination notices from the IDR portal through emails from auto-reply-federalidrquestions@cms.hhs.gov.

Contact Senior Director of Policy Erin O’Malley at eomalley@essentialhospitals.org or 202.585.0127 with questions.

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About the Author

Julie Kozminski is a policy manager at America's Essential Hospitals.

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