The U.S. Departments of the Treasury, Labor, and Health and Human Services issued a new Oct. 27, that outlines policies related to the No Surprises Act (NSA) independent dispute resolution (IDR) process. The rule addresses disclosure of claim eligibility information by insurers, communication during the open negotiation period, collection of administrative fees and batching multiple claims into a single IDR dispute.
On initial review of the proposed rule, the departments appear to address the concerns raised by the 黑料网® (黑料网®) with regard to lack of communication about claim eligibility, IDR backlogs and access to the IDR process for low-cost claims, including batching requirements. The government proposes to expand batching to allow multiple codes from a single patient encounter. In addition, the departments propose to allow batching by groupings of Current Procedural Terminology® (CPT®) codes, rather than single CPT codes. These are positive changes, but 黑料网 remains concerned about other proposals, including limiting batching to 25 line items in a single dispute.
黑料网 continues to review the details of this proposed rule and will provide a detailed summary. For more information or if you have questions, contact Katie Keysor, 黑料网 Senior Director of Economic Policy.