Updates on the No Surprises Act’s Independent Dispute Resolution (IDR) Process
The federal provider-payer dispute resolution process requires new fees
What
The passage of the federal No Surprises Act, which protects patients from excessive out-of-network charges, includes a mechanism for physicians and health plans to resolve billing disputes while leaving the patient harmless – this is called the independent dispute resolution (IDR) process. Initially, each party was required to pay a $50 administrative fee, but given the large number of disputes, it was raised to $350 per party per dispute for calendar year 2023. The Texas Medical Association contested this raise in fees, among other issues, and the U.S. District Court for the Eastern District of Texas vacated the new proposed fee. As a result, the federal agencies published a new final rule setting the fee at $115 per party.
When
The U.S. Departments of Health & Human Services, Labor, and Treasury jointly released the IDR fee updates in a final rule on December 21, 2023, with an effective date of January 22, 2024. All disputes initiated after the effective date will be required to pay the new administrative fee.
