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FAH Offers Recommendations to Cabinet Secretaries for Independent Dispute Resolution in No Surprises Act

FAH submitted a letter to three members of President Biden’s Cabinet reiterating support of the No Surprises Act and offering recommendations for implementation of the independent dispute resolution (IDR) process under the law. 

FAH President and CEO Chip Kahn wrote in the letter that our members support the law and its goal of protecting patients from, “surprise medical bills by holding the patient to in-network cost-sharing in circumstances where the patient has no reasonable control over the network status of the providers administering care.” He added, “Congress also importantly preserved the role of health plan and provider payment negotiations while creating a process to fairly resolve payment disputes.  It is imperative that the implementing regulations and independent dispute resolution process advance and actively maintain that fairness so as not to inappropriately advantage health plans at the expense of patients and their health care providers.”  

In the letter, which was sent to HHS Secretary Xavier Becerra, Labor Secretary Marty Walsh, and Treasury Secretary Janet Yellen, FAH outlined key recommendations, which include:

  • Importance of the IDR considering all relevant information submitted by providers for determining payment for an out-of-network service;
  • Flexibility in IDR timelines to allow proper, fair, and timely consideration of provider submissions; 
  • Flexible and broad-based batching of claims for IDR consideration; and 
  • Ensuring IDR entities have appropriate knowledge and expertise and sufficient staffing; are free from conflicts of interest; and are monitored by the federal government agencies to ensure their compliance with the law.

You can read the entire letter here