Lexology February 15, 2023
The No Surprises Act directs the Departments of Treasury, Labor, and Health and Human Services (the “Departments”) to establish a Federal Independent Dispute Resolution Process (the “Federal IDR Process”), including dispute arbitration rules that must be followed by nonparticipating facilities, nonparticipating providers, nonparticipating air ambulance services, group health plans, and health insurance issuers to resolve disputes that cannot be successfully negotiated. The Federal IDR Process is used following the end of an open negotiation period to determine the out-of-network rate for out-of-network emergency services, certain items and services provided by nonparticipating providers at in-network facilities, and the payment for qualified services provided by nonparticipating providers of air ambulance services, when a specified state law or All-Payer Model Agreement does not...
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