Federal Surprise Billing Independent Dispute Resolution (IDR) Portal Now Active
The Centers for Medicare and Medicaid Services (CMS) announced that the Independent Dispute Resolution (IDR) portal, which allows providers to initiate the IDR process under the No Surprises Act, is now active.
Additional Information and Resources:
- No Surprises Act summary
- Webinar on IDR process
- Guidance for disputing parties
- Revised guidance to IDR entities detailing the IDR process and requiring the arbiters to consider a series of factors when making a payment determination without giving undue weight to the plan’s median in-network rate or Qualifying Payment Amount (QPA)
- Toolkit outlining the payment process
- No Surprise Act resources, letters, and litigation updates
- Recent Summary article federal portal and No Surprise Act
Ohio Specific Surprise Billing Law and Portal
A reminder that Ohio has its own surprise billing law and arbitration process. All state regulated plans are subject to this law instead of the federal law. OSMA has provided members with updates on the state law and portal in emails earlier this year. A listing of those articles is below. If you have questions about the state law or process, please email OSMA at email@example.com.