Federal Independent Dispute Resolution (IDR) Portal LaunchedApril 15, 2022, the Centers for Medicare & Medicaid Services opened the Federal Independent Dispute Resolution (IDR) process for providers (including air ambulance providers), facilities, and health plans and issuers to resolve payment disputes for certain out-of-network charges. To start a dispute, an initiating party will need:
At the end of the 30-business-day open negotiation period, initiating parties have 4 business days to initiate a dispute via the portal. As a result of the recent decision in Texas Medical Ass’n, et al. v HHS, the Departments will give disputing parties whose open negotiation period expired before today, April 15, 2022, 15 business days to file an initiation notice via the IDR Portal. Even after starting the Federal IDR process, disputing parties can continue to negotiate until the IDR entity makes a determination. If the parties reach an agreement on the out-of-network payment rate, they should email the certified IDR entity and the Departments (at [email protected]). If the disputing parties experience extenuating circumstances during the IDR process that prohibit them from complying with deadlines to submit information, they may email the Departments (at [email protected]) to receive a Request for Extension Due to Extenuating Circumstances form and instructions for next steps. To learn more about the independent dispute resolution process, including to read guidance materials, FAQs, and model notices, visit www.cms.gov/nosurprises |