By: Karen George
The Final Rule becomes effective Oct. 25, 2022.
The U.S. Departments of Health and Human Services, Labor and Treasury (the Departments) have issued the highly anticipated final rule further implementing the independent dispute resolution (IDR) process under the No Surprises Act (NSA).
This follows two recent federal court decisions (Texas Medical Association, et al. v. United States Department of Health and Human Services, et al. and LifeNet, Inc. v. United States Department of Health and Human Services, et al.) where the court vacated portions of the interim final rules requiring arbitrators in the IDR process to presume that the insurer’s median in-network rate (i.e., Qualifying Payment Amount) is the appropriate out-of-network rate.
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