Federal Agencies Finalize Overhaul of No Surprises Act Dispute Resolution Process
The US Departments of Treasury, Labor, and Health and Human Services have issued a sweeping final rule ( CMS -9897-F) implementing significant changes to the Federal Independent Dispute Resolution ( IDR ) process established under the No Surprises Act ( NSA ). This final rule has been long awaited by stakeholders, as changes were proposed by the Departments back in late 2023. It requires health insurers and plans (payers) to provide additional information on initial explanations of benefits (EOBs), reduces administrative fees to $15 per party per dispute, expands batching requirements, and implements substantial procedural reforms to the open negotiation and IDR initiation processes. These changes represent the most comprehensive revisions to the federal IDR process since its inception in 2022. The rule itself will become effective 60 days after it is published in the Federal Register, but some of its provisions will be implemented later. As background, US Congress passed the NSA to ...