The independent dispute resolution process can be initiated to resolve payment disputes between health care providers and issuers.

Two new documents provide guidance for health care providers on No Surprises Act compliance and good faith estimates for uninsured or self-pay patients.

The court ruled the qualifying payment amount should not be the main factor in determining payment for out-of-network services in independent dispute resolution.

The Centers for Medicare & Medicaid Services released guidance and example templates for good faith estimates and the surprise billing patient-provider dispute resolution process.

New guidance from the Centers for Medicare & Medicaid Services reviews the timeline for open negotiations and initiating the federal independent dispute resolution process under the No Surprises Act.

The new document explains various provisions under part II surprise billing regulations, including that all financial assistance should be reflected in the good faith estimate regardless of the amount or type of discount. The new regulations take effect Jan. 1, 2022.

America’s Essential Hospitals commented on the second interim final rule implementing the No Surprises Act. The association urged HHS to revise good faith estimate requirements and create an IDR process that does not favor payers over providers.

America’s Essential Hospitals and members of Congress agree: the interim rule does not accurately reflect congressional intent. Instead, it includes a lopsided IDR method that favors insurers.

The departments of Health and Human Services (HHS), Treasury, and Labor and the Office of Personnel Management issued Part II of the No Surprises Act interim final rule with comment period.

In a letter to the Centers for Medicare & Medicaid Services, America's Essential Hospitals commented on the first interim final rule implementing the No Surprises Act. The association urged HHS to delay implementation until after the COVID-19 public health emergency, among other requests.

The rule, released by the departments of Health and Human Services, the Treasury, and Labor and the Office of Personnel Management, bars health care insurers, carriers, and providers from billing patients more than in-network cost sharing amounts in certain circumstances.

On July 1, the Biden administration released part 1 of the No Surprises Act interim final rule. Passed as part of the Consolidated Appropriations Act of 2021, the rule establishes new patient protections from balanced billing and excessive cost-sharing, known as surprise billing.

The $2.3 trillion package to fund the government, provide new COVID-19 relief, and stimulate the economy would eliminate a $4 billion cut to Medicaid disproportionate share hospital payments and add $3 billion to the Provider Relief Fund, among numerous other changes.

The continuing resolution delays until Dec. 19 a scheduled $4 billion cut to Medicaid disproportionate share hospital payments. Meanwhile, lawmakers introduce a new, two-part $908 billion legislative proposal for COVID-19 relief, as well as a deal on legislation regarding surprise medical bills.

The Ways and Means legislation would preserve the ability of providers and health plans to negotiate payment rates through independent dispute resolution, while the Education and Labor plan would impose federal benchmark rates for charges of more than $750.

In its bipartisan proposal on surprise medical bills, the House Committee on Ways and Means would preserve the ability of providers and health plans to negotiate the payment rate for out-of-network care. Also, the president releases his FY 2021 budget plan, including $920 billion in Medicaid cuts.