Ways & Means Leaders Oppose IDR Process in Surprise Billing Guidance

October 6, 2021

In a letter to Biden Administration leaders, House Ways & Means Committee Chair Richard Neal (D-MA) and Ranking Member Kevin Brady (R-TX) expressed concern about several proposals in an additional interim final rule implementing provisions of the No Surprises Act—particularly provisions governing the independent dispute resolution (IDR) process.

The attached letter explains that the interim final rule essentially tips the scale in favor of the median contract rate as the default payment amount, which biases the IDR entity toward one factor instead of evaluating all factors equally. The letter asks the Administration to consider adjusting the interim final rule to better align it with Congress’s original intent.

The No Surprises Act, which holds patients harmless from surprise medical bills, was signed into law in December 2020 as part of the Consolidated Appropriations Act of 2021 (P.L. 116-260). Most provisions in the regulations will go into effect January 1, 2022. Comments on the interim final rule are due 60 days after publication in the Federal Register, which is scheduled for October 7.

Please see ML-95 and the Centers for Medicare & Medicaid Services website for additional details on the interim final rule.

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