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Ep 8 - Courts Reject No Surprises Act IDR Rule – What Does This Mean for Providers and Payers?
On January 1, 2022, the No Surprises Act took effect to protect patients from surprise medical expenses, but it has created tension between payers and providers. For example, on February 23, 2022, the U.S. District Court for the Eastern District of Texas struck down the part of the interagency interim final rule implementing the “independent dispute resolution” (IDR) procedures.
When payers and out-of-network providers cannot agree on reimbursement, either party can choose to initiate an IDR. While the majority of the rule remains in effect, the changes from this case will impact health plans and the insurers that sponsor them.
These were the key themes of a recent Future Healthcare Today podcast interview with Matthew Albright, Chief Legislative Affairs Officer at Zelis, and Cate Brantley, Legislative Analyst at Zelis, who provided a deep-dive perspective on the IDR process and its impact on health payers.
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By Future Healthcare TodayOn January 1, 2022, the No Surprises Act took effect to protect patients from surprise medical expenses, but it has created tension between payers and providers. For example, on February 23, 2022, the U.S. District Court for the Eastern District of Texas struck down the part of the interagency interim final rule implementing the “independent dispute resolution” (IDR) procedures.
When payers and out-of-network providers cannot agree on reimbursement, either party can choose to initiate an IDR. While the majority of the rule remains in effect, the changes from this case will impact health plans and the insurers that sponsor them.
These were the key themes of a recent Future Healthcare Today podcast interview with Matthew Albright, Chief Legislative Affairs Officer at Zelis, and Cate Brantley, Legislative Analyst at Zelis, who provided a deep-dive perspective on the IDR process and its impact on health payers.