Surprise Medical Billing for Group Health Plans: Independent Dispute Resolution (IDR) Process (Part II) | Practical Law

Surprise Medical Billing for Group Health Plans: Independent Dispute Resolution (IDR) Process (Part II) | Practical Law

A Practice Note addressing federal independent dispute resolution (IDR) procedures regarding surprise medical billing requirements for group health plans and health insurers, as enacted under the No Surprises Act (NSA). The NSA's IDR requirements were addressed in extensive implementing regulations issued by the federal administrative agencies (in interim final form) in October 2021. The regulations include detailed payment dispute resolution procedures for plans, insurers, and health providers regarding NSA-covered items and services. In August 2022, the Departments issued regulations that finalized select provisions of the October 2021 interim final regulations. However, parts of the August 2022 final regulations were invalidated by court order in February 2023.

Surprise Medical Billing for Group Health Plans: Independent Dispute Resolution (IDR) Process (Part II)

by Practical Law Employee Benefits & Executive Compensation
MaintainedUSA (National/Federal)
A Practice Note addressing federal independent dispute resolution (IDR) procedures regarding surprise medical billing requirements for group health plans and health insurers, as enacted under the No Surprises Act (NSA). The NSA's IDR requirements were addressed in extensive implementing regulations issued by the federal administrative agencies (in interim final form) in October 2021. The regulations include detailed payment dispute resolution procedures for plans, insurers, and health providers regarding NSA-covered items and services. In August 2022, the Departments issued regulations that finalized select provisions of the October 2021 interim final regulations. However, parts of the August 2022 final regulations were invalidated by court order in February 2023.