When a federal court in Texas rejected an increase in the fee for providers to initiate payment challenges under the No Surprises Act’s Independent Dispute Resolution process, the Centers for Medicare & Medicaid Services quickly suspended use of that process while it reviewed the court ruling – suspended both the adjudication of current complaints and the filing of new ones.
Almost as quickly, CMS announced that it would reduce the fee required to initiate payment disputes between providers and payers under the 2020 law that sought to prevent surprise medical bills from $350 to $50 – but it did not relaunch the process.
Instead, CMS posted an FAQ explaining its response to the court ruling. In that FAQ it noted that
These FAQs are not announcing the reopening of the Federal IDR portal to submit new disputes. The Departments intend to reopen the portal to permit the submission of new disputes soon and will notify interested parties at that time.
The court also vacated the manner in which the process addresses batched claims, concluding that it was implemented outside the required rulemaking process.
Find the CMS FAQ here.