CHA News

CMS Opens Federal Independent Dispute Resolution Process

For CEOs, CFOs, government relations executives, finance & reimbursement staff, legal counsel

On April 15, the Centers for Medicare & Medicaid Services (CMS) opened the federal independent dispute resolution (IDR) process for providers to resolve out-of-network payment issues covered under the No Surprises Act (NSA). 

At the end of the 30-business-day open negotiation period required by the NSA, the initiating party has four business days to initiate a dispute via the portal. As a result of the delay in opening the portal, CMS will give disputing parties 15 business days (May 6) to file an initiation notice via the IDR portal if their open negotiation period expired before April 15. 

In announcing the opening of the portal, CMS reminds providers and health plans that they may continue negotiating after the initiation of the IDR process. Should the parties reach an agreement, they must notify the IDR entity and the agencies by emailing [email protected].   

CMS has also recently released a number of resources to help providers navigate the IDR process. CHA has posted these resources under the CMS guidance tab on its NSA resource page.