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- Federal IDR Process Administrative Fee Final Rule Released
On December 18, the Department of Health and Human Services (HHS), jointly with the Departments of Labor and the Treasury, issued a final rule outlining the fees for the Federal Independent Dispute Resolution (IDR) process under the No Surprises Act. The CAP argued that especially with the administrative fee, as it is non-refundable, ANY increase in the fee amount imposes added burdens and potentially a complete barrier for physicians in accessing the federal IDR process. The CAP believes it is vital that any fee requirements take into consideration low-dollar claims and ensure an even and fair playing field for all IDR parties.
Acknowledging these concerns, this rule finalizes an administrative fee amount of $115 per party for disputes initiated on or after the effective date of this rule, down from the proposed $150. It finalizes an IDR entity fee range of $200-$840 for single determinations and $268-$1,173 for batched determinations for disputes initiated on or after the effective date of the rule. However, the Departments are in the process of additional rulemaking around the IDR process and its fees, including a reduced administrative fee for low dollar claims as requested by the CAP. The CAP will submit comments on this latest rulemaking by the deadline of January 2, 2024.