Remark Interval for the No Surprises Act Proposed Rule, “Federal Impartial Dispute Decision (IDR) Operations,” Will Reopen

On January 17, 2024, the Departments of Well being and Human Companies, Labor, and the Treasury (collectively, the “Departments”) and the Workplace of Personnel Administration issued a discover that they’ll reopen the interval for submitting feedback on the proposed rule, “Federal Impartial Dispute Decision (IDR) Operations” (the “Proposed Rule”) beneath the No Surprises Act (the “Act”).

The Proposed Rule would set up new necessities for the disclosure of data that group well being plans and medical health insurance issuers providing group or particular person medical health insurance protection should embrace together with the preliminary fee or discover of denial of fee for sure gadgets and providers topic to the shock billing protections within the Act. The Proposed Rule would:

• Require plans and issuers to speak info through the use of declare adjustment cause codes (“CARCs”) and remittance recommendation comment codes (“RARCs”), as laid out in steering, when offering any paper or digital remittance recommendation to an entity that doesn’t have a direct or oblique contract with the plan or issuer.
• Amend sure necessities associated to the open negotiation interval previous the Federal IDR course of, the initiation of the Federal IDR course of, the Federal IDR dispute eligibility evaluate, and the fee and assortment of administrative charges and authorized IDR entity charges.
• Outline bundled fee preparations, amend necessities associated to batched gadgets and providers, and amend the principles for extensions of timeframes as a result of extenuating circumstances.
• Require plans and issuers to register within the Federal IDR portal.

The unique remark interval closed on January 2, 2024. It will likely be reopened from the date the reopening of the remark interval is revealed within the Federal Register (which is predicted to be on January 22, 2024) to 14 days after that date.

You’ll find extra info concerning the Act on the Sheppard Mullin Healthcare Weblog.