The Centers for Medicare & Medicaid Services (CMS) in a Feb. 10 notice instructed certified Independent Dispute Resolution (IDR) entities to hold all payment determinations under the No Surprises Act pending further guidance from the Department of Health and Human Services, the Department of Labor, and the Department of the Treasury (the Departments).
This instruction follows a Feb. 6 ruling of the U.S. District Court for the Eastern District of Texas that invalidates the dispute resolution rules, which the American Medical Association (AMA) and others have stated “conflict with the clear-cut language in the statute. The court’s decision is an important confirmation of the shared consensus among physicians, hospitals, and lawmakers that federal agencies exceeded their statutory authority and created rules that ignored the [No Surprises] Act’s requirements for a balanced and independent arbitration process,” AMA President Jack Resneck Jr., M.D., wrote in a statement.
In the Feb. 10 notice, CMS said the Departments are currently evaluating and updating Federal IDR process guidance, systems, and related documents to make them consistent with the Texas court decision. “Effective immediately, certified IDR entities should not issue new payment determinations until receiving further guidance from the Departments,” CMS writes.
Additionally, certified IDR entities should recall any payment determinations issued after Feb. 6 and should continue working through other parts of the IDR process while they wait for additional direction.
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