DecisionHealth, DecisionHealth - 2022 Issue 9 (September)

No Surprises IDRs stall, but new rules more likely to favor providers

Several federal agencies recently issued a set of final rules based on the No Surprises Act (NSA) that affects out-of-network reimbursement of providers. These rules should make it easier for providers to contest payer decisions — that is, if CMS can break the logjam in its independent dispute resolution (IDR) process, which experts caution the new rules may worsen.

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