Independent Dispute Resolution process

Controversy Over No Surprises Act Continues

Providers and payers continue to wage war over how the No Surprises Act is being implemented. The law, enacted in 2020, was intended to prevent insured consumers from receiving surprise medical bills, especially for out-of-network care. While it has achieved that objective to a considerable degree, it has left behind providers complaining they are being underpaid for their services and payers – health insurers – insisting that the process of adjudicating such disputes, through what is known as the Independent Dispute Resolution process, is forcing them to pay far too much for providers’ services. At the heart of the debate [...]

joe2025-12-17T12:57:49-05:00December 18, 2025|Uncategorized|

No Surprises Act’s Dispute Resolution Suspended

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 [...]

iqtsupport2023-08-18T06:00:20-04:00August 18, 2023|Uncategorized|

Federal Health Policy Update for August 10

The following is the latest health policy news from the federal government for August 4-10. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has temporarily suspended the federal Independent Dispute Resolution process, which adjudicates problems involving surprise medical bills, in the wake of a federal court ruling that found some of the process’s underlying regulations invalid. CMS has directed the certified Independent Dispute Resolution entities to pause all dispute resolution activities. As a result, providers and insurers temporarily cannot initiate new disputes. Learn more from this CMS notice. CMS [...]

iqtsupport2023-08-10T16:32:27-04:00August 10, 2023|Alternative payment models, Centers for Medicare & Medicaid Services, COVID-19, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare reimbursement policy, MedPAC, Telehealth|