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CMS Releases Revised Surprise Billing Rules & Clarifies Processes


On August 19, CMS announced several updates to the federal No Surprises Act implementation. These rules relate to those covered by insurance plans regulated by the federal government.

A reminder that claims related to individuals covered by insurance plans regulated by the state of Ohio are subject to different out-of-network rules administered by the Ohio Department of Insurance.

In addition to releasing new rules (as required by recent court rulings), CMS and the Department of Labor released new FAQs covering a variety of NSA requirements, an update on the Independent Dispute Resolution Process (IDR) including tips, and common mistakes and helpful guidance for those entities conducting the IDR process.

Federal No Surprises Act Resources

New Federal NSA Rule 

NSA Requirements FAQ

Federal IDR Process Update

Federal IDR Process Tips and Common Mistakes 

Guidance for IDR Entities 

Ohio Surprise Billing Resources
(for state regulation insurance)

Surprise Billing Toolkit



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