Lower Fee Now in Effect to File No Surprises Act Disputes

Federal agencies released a final rule May 28 that updates the No Surprises Act independent dispute resolution process. ACR^® created a detailed summary focused on changes that affect radiology providers.

The rule lowers the IDR administrative or filing fee from $115 to $15 for disputes filed on or after June 11. ACR supported the change because many radiology claims are worth less than the previous fee amount.

The rule also expands batching rules and requires insurers to include more information about IDR eligibility when they send payment notices or denials.

The College is disappointed that the final rule does not include enforcement mechanisms for insurers who do not pay providers what is owed after IDR determinations. ACR will continue to advocate for Congress to pass the No Surprises Act Enforcement Act, which would allow the CMS to impose penalties on insurers who refuse to pay in a timely manner.

If you have questions or for more information, contact Katie Keysor, ACR Senior Director of Economic Policy.