Over the past month, CMS announced several updates to the Federal No Surprises Act IDR Process. On December 15, 2023, the Federal IDR portal was re-opened for all remaining disputes. The portal is now open for all disputes including single disputes involving air ambulance services and new and previously initiated batched disputes. On December 18, 2023, the Department of Health and Human Services, Treasury, and Labor (the Departments) issued a final rule that set forth the fees for participating in the Federal IDR Process. On December 22, 2023, the Departments issued a notice that they would reopen the comment period for submitting comments on the Federal IDR Operations proposed rule.
Federal IDR Portal Reopening. The Federal IDR portal has been reopened to process all dispute types. The Departments are also extending the IDR deadlines for selecting a certified IDR entity, initiating certain disputes, and resubmitting improperly batched disputes. The new deadlines are available here. If a party’s IDR initiation deadline fell between August 3, 2023 and December 14, 2023, the party will have until March 14, 2024 to initiate a new dispute. March 14, 2024 is also the deadline for any party whose IDR initiation deadline falls between December 15, 2023 through March 13, 2024. If a party’s initiation deadline falls on March 14, 2024 or after, the usual deadlines will apply. This is the second extension that the Departments have granted due to the backlog of actions that parties could not file while the portal was suspended.
Federal IDR Fees. The Departments issued a final rule to establish new fees that will go into effect on January 22, 2024. Between August 3, 2023 and January 21, 2024, each party will pay $50 per dispute. For disputes initiated on or after January 22, 2024, the administrative fee will increase to $115 per party per dispute. The rule also sets the certified IDR entity fee range for single determinations ($200-$840) and for batched determinations ($268-$1,173). This new rule is being issued because the Texas Medical Association, et al. v. U.S. Department of Health & Human Services, et al., No. 6:23-cv-00059-JDK (TMA IV) order and memorandum vacated portions of the previous rule on August 3, 2023. The CMS Fact Sheet with more details about these fees is available here.
Extensions Available Through March 14, 2024. The Departments also announced a few other extensions that are available through March 14, 2024. A party may request additional time to respond to a Certified IDR entity’s request for information. A Certified IDR entity may grant a party’s request for a 10-business day extension to submit an offer after the original offer deadline. Finally, if parties initiate a dispute before March 15, 2024, the parties will have 10 business days to jointly select a certified IDR entity.
Re-Opening the Comment Period. CMS posted a notice on the No Surprises Act website announcing that the Departments intend to re-open the comment period for submitting comments on the proposed rule “Federal Independent Dispute Resolution (IDR) Operations.” Additional information on the IDR Operations Proposed Rule is available in a prior issue of Health Headlines. Interested parties should monitor the Federal Register for a notice with details about the comment period reopening.
