no surprises act independent dispute resolution

Federal Health Policy Update for May 2

The following is the latest health policy news from the federal government for April 26 – May 2. Some of the language used below is taken directly from government documents. No Surprises Act – Independent Dispute Resolution Process CMS has announced a new process for resubmitting Independent Dispute Resolution (IDR) disputes that were originally improperly batched or bundled.This new resubmission process is automated in the federal IDR portal and seeks to streamline federal IDR operations. For further information about this new process and an implementation timetable, see this CMS announcement. CMS also has posted a user guide for the IDR [...]

joe2024-05-02T19:49:55-04:00May 2, 2024|Centers for Medicare & Medicaid Services, COVID-19, health equity, hospitals, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy|

Federal Health Policy Update for April 18

The following is the latest health policy news from the federal government for April 12-18. Some of the language used below is taken directly from government documents. The White House The administration has launched a new global health security strategy that seeks to drive action across federal departments and agencies and rally support from other countries, the private sector, and civil society to better prevent, detect, respond to, and recover from infectious disease threats. The strategy seeks to build on the lessons learned from the response to the COVID-19 pandemic. Learn more from this White House statement; the administration’s strategy [...]

joe2024-04-18T19:03:57-04:00April 18, 2024|340b, Centers for Medicare & Medicaid Services, COVID-19, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare regulations, MedPAC|

Federal Health Policy Update for November 30

The following is the latest health policy news from the federal government for November 17-30. Some of the language used below is taken directly from government documents. No Surprises Act CMS has released two new FAQs to provide guidance in advance of the Independent Dispute Resolution portal reopening for batched disputes and air ambulance disputes; that service remains temporarily suspended. These FAQs together explain how certified IDR entities may determine whether a dispute is appropriately batched in light of recent court rulings; provide information about policy for extending existing IDR deadlines once the federal IDR portal reopens to all batched [...]

joe2023-11-30T20:59:02-05:00November 30, 2023|Centers for Medicare & Medicaid Services, COVID-19, Federal Update, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy|

Court Again Sets Back No Surprises Act Implementation

For the second time in less than a month, a federal court has rejected the manner in which federal agencies are implementing the Independent Dispute Resolution process of the No Surprises Act, the 2020 law designed to protect consumers from surprise medical bills. In its ruling the court found that the process established by federal agencies to establish the Qualifying Payment Amount, or QPA, which is the median rate insurers pay for in-network services and a critical factor in adjudicating payment disputes between providers and payers, inappropriately permits insurers to depress that rate – a result the court likened to [...]

iqtsupport2023-08-30T06:00:15-04:00August 30, 2023|Centers for Medicare & Medicaid Services|

Federal Health Policy Update for January 5

The following is the latest health policy news from the federal government for December 23 through January 5. Some of the language used below is taken directly from government documents. No Surprises Act HHS, the Department of Labor, and the Department of the Treasury have announced increases in the administrative fee for initiating the No Surprises Act’s Independent Dispute Resolution (IDR) process and for certified IDR entities. Learn more about the administrative fee change here and about the certified IDR entity fee change here. Both changes took effect on January 1. HHS, the Department of Labor, and the Department of the [...]

iqtsupport2023-01-05T17:15:07-05:00January 5, 2023|Centers for Medicare & Medicaid Services, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid regulations, Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for December 15

The following is the latest health policy news from the federal government for the week of December 12-15. Some of the language used below is taken directly from government documents. White House The White House has unveiled its “COVID-19 Winter Preparedness Plan,” the major components of which are expanding easy access to free COVID-19 testing options in the winter; making vaccinations and treatments readily available as cases rise; preparing personnel and resources; and focusing on protecting the highest-risk Americans. Learn more about the plan from this White House fact sheet and go here for a transcript of the White House [...]

Federal Health Policy Update for Thursday, April 21

The following is the latest health policy news from the federal government as of 2:45 p.m. on Thursday, April 21. Some of the language used below is taken directly from government documents. Proposed FY 2023 Medicare Inpatient Prospective Payment System Regulation CMS has published its proposed FY 2023 Medicare inpatient prospective payment system regulation outlining how it envisions paying hospitals for the inpatient care they provide to Medicare patients in the coming fiscal year. Highlights of the proposed regulation include: A proposed 3.2 percent increase in inpatient rates and a 0.7 percent increase in LTCH rates. A $654 million cut [...]

iqtsupport2022-04-21T17:30:19-04:00April 21, 2022|Centers for Medicare & Medicaid Services, COVID-19, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|