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- CMS Releases IDR Chart, Other No Surprises Act Resources
On April 12, the CMS released additional guidance on the No Surprises Act, including a chart for the Independent Resolution (IDR) Process, FAQs surrounding the new surprise billing requirements, and requirements related to providing good faith estimates. The CAP had urged Congress to hold patients harmless from bills for out-of-network services provided at in-network hospitals or facilities and now engages with the administration on the implementation of the No Surprises Act.
As part of additional guidance regarding the No Surprises Act, the CMS released a high-level chart that helps determine whether the federal IDR process or the state process applies in a particular state. Under the No Surprises Act, a state law on balance billing will still apply unless the federal law provides further protection.
Additional CMS No Surprises Act guidance outlines how providers and health care facilities must publicly disclose patient protections against balance billing. According to the new guidance, providers must also give a good faith estimate of expected charges to uninsured or self-pay patients at least three business days before a scheduled service (or upon request).