What’s happening: The Centers for Medicare & Medicaid Services released publicly available independent dispute resolution (IDR) reports for the first two quarters of reporting year 2023.
What else to know: The report includes certain data submitted by disputing parties and certified IDR entities to the No Surprises Act (NSA) federal IDR portal.
The data show that health care providers and facilities won 72% of the 24,305 payment disputes where a payment determination was made involving out-of-network emergency and non-emergency items and services in the first quarter of 2023, and 79% of the 53,806 payment disputes where a payment determination was made involving these items and services in the second quarter of 2023.
The NSA requires the Departments of Health and Human Services, Labor, and the Treasury to publish certain information about the IDR process for each calendar quarter on a public website.
