The Centers for Medicare & Medicaid has officially dropped the per-party fee for resolving payment disputes under the No Surprises Act back down to $50, the agency announced Friday.
CMS revealed the change in a FAQ fact sheet, noting that it also is lifting restrictions forbidding physicians from “batching” together similar claims in a single dispute. The update comes in response to a Texas judge’s ruling, which temporarily paused the IDR process and struck down two key pieces of legislation aimed at reining in surprise medical bills.
“These FAQs are not announcing the reopening of the Federal IDR portal to submit new disputes,” CMS said Aug. 11. The departments [of Health & Human Services, Labor and Treasury] intend to reopen the portal to permit the submission of new disputes soon and will notify interested parties at that time.”
CMS is reverting the fee from $350 back to $50, where it will remain for disputes initiated on or after Aug. 3, until the departments decide to set a new amount. The cost will remain $350 for already-paid administrative fees pertaining to disputes initiated between Jan. 1 and Aug. 2 of this year, and the court order does not require refunds for such invoices. However, CMS is ordering dispute-resolution entities to cancel outstanding, unpaid invoices—relating to any disputes initiated in 2023—and resend replacement IOUs with the $50 fee.
Find further details in the frequently asked questions document here.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.