No Surprises Act Arbitration Decisions Resume

After revising its guidelines on how certain medical fee disputes should be resolved, the Centers for Medicare & Medicaid Services has directed the Independent Dispute Resolution entities responsible for arbitrating fee disputes between payers and providers to resume making and issuing their decisions.

After a February ruling in federal court that aspects of CMS’s implementation of the 2020 No Surprises Act contradicted the language of the act itself and unfairly favored payers over providers, CMS ordered a moratorium on new arbitration decisions for disputes filed on or after October 25, 2022 while it reviewed and revised its guidance on how those disputes should be decided.  Now, CMS has completed that task and issued new guidance to the Independent Dispute Resolution entities that adjudicate the disputes and to the parties in those disputes.

Go here to see the new CMS guidance to the parties in disputes and here for the guidance to the Independent Dispute Resolution entities.


Leave a Reply