No Surprises Act Resources & Information

Note: latest information is added at the top

• Federal Launch of the Independent Dispute Resolution (IDR) Process
  In response to the successful lawsuit by the Texas Medical Association (TMA) to stop the federal government’s reliance on the median in-network rate to determine physician and facility payments, CMS released new FAQs in April to implement the IDR under the No Surprises Act.
  • — CMS’s updated FAQs
  • — Updated FAQs on good faith estimates
  • — CMS’s overview of the No Surprises Act and the payment dispute process

• Federal Independent Dispute Resolution (IDR) Process Guidance
  • — For Certified IDR Entities: overview of the IDR process and their responsibilities as part of the process
  • — For Disputing Parties: a health care provider, facility, or provider of air ambulance services, and a plan, issuer, or carrier are the “disputing parties” to the Federal IDR Process. How disputing parties engage in open negotiation prior to the Federal IDR Process, initiate the Federal IDR Process, select a certified IDR entity, and meet the requirements of the Federal IDR Process.

• TSA Applauds ASA, ACEP, ACR Suit Taking Action Against the ‘No Surprises Act’ Implementation Rules
• TSA Letter of Support for TMA’s Suit Challenging the Implementation of the ‘No Surprises Act’.
• ASA Surprise Billing Resources (ASA Members Only)