No Surprises Act Independent Dispute Resolution Process: Training Available

No Surprises Act Independent Dispute Resolution Process: Training Available

As a reminder the No Surprises Act became applicable January 1, 2022. See our prior article here. One of the Act’s requirements is resolution of disputes through a newly created Independent Dispute Resolution (IDR) process.

The Centers for Medicare and Medicaid Services (CMS) has released a brief FAQ document regarding the No Surprises Act (1) Independent Dispute Resolution Process and (2) the Model Standard Notice and Consent requirement.

Notice and Consent

The Model Standard Notice and Consent applies to out-of-network facilities and providers who wish to issue a balance bill to a patient (as an exception to the No Surprises prohibition on balance billing). The previously issued model notices, set to expire on 3/31/2022, are replaced by revised model notices (published 11/9/2021). See Overview of rules & fact sheets | CMS

Providers and facilities who seek to issue a balance bill must provide notice and obtain consent. If a patient declines to consent, the facility/provider is not required to provide the item/service. However, if the facility/provider provides the item/service without the patient consent, the facility/provider cannot issue a balance bill.

IDR Process

The Centers for Medicare and Medicaid Services (CMS) will begin offering technical trainings and webinars on the use of the Independent Dispute Resolution process. Information will be forthcoming in the following weeks regarding these sessions. 


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No Surprises Act Independent Dispute Resolution Process: Training Availablehttps://www.cbiz.com/Portals/0/Images/No Surprises Act.jpg?ver=2fiIaaMqibzrQw4KbxRisA%3d%3dNew model notices are available. IDR process training expected soon.2022-01-11T20:00:00-05:00New model notices are available. IDR process training expected soon.Regulatory, Compliance, & LegislativeEmployee Benefits ComplianceNo