November 10, 2023

ACR Releases Detailed Summary of Pros and Cons in IDR Proposed Rule

The U.S. Departments of the Treasury, Labor, and Health and Human Services released a proposed rule Oct. 27 outlining rules related to the federal independent dispute resolution (IDR) process initiated by the No Surprises Act (NSA).

The American College of Radiology® (ACR®) prepared a detailed summary of the provisions of the rule with the greatest impact on radiology. The College is encouraged that the departments recognized and proposed policy changes to address concerns raised about imaging providers’ access to the IDR process. Specifically, the proposed rule would: provide expanded batching regulations, reduce the administrative fee for low-dollar claim disputes, and require insurers to provide claim eligibility information with initial payments. These are positive changes recommended by many specialty societies, including ACR. The College still has issue with some details within the proposed rule, including limiting batching to 25-line items in a single dispute.

The government focused the proposed rule on streamlining the IDR process to make it more efficient and avoid backlogs. One of the most burdensome aspects of IDR is determining claim eligibility. The departments propose requiring more meaningful engagement by all parties in the open negotiation process.

ACR will submit comments on the rule during the comment period. For more information or if you have questions, contact Katie Keysor, ACR Senior Director of Economic Policy.