Lexology December 8, 2022
Pressure continues to mount on the US Department of Health and Human Services (HHS) to reconsider and revise its August 2022 final rule modifying the No Surprises Act independent dispute resolution (IDR) process. The rule is an attempt to revise the original IDR process, which “placed its thumb on the scale” for payors, according to the February 2022 federal district court decision in Texas Medical Association v. US Department of Health and Human Services.
According to the US District Court for the Eastern District of Texas, HHS’s interim final rule defied the plain language of the No Surprises Act by establishing a rebuttable presumption in favor of the qualifying payment amount (QPA) (generally, the median contracted rate in the market...
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