New Proposed Fees for Federal Independent Dispute Resolution (IDR) Process Under No Surprises Act
The Departments of Health and Human Services, Labor, and the Treasury (the Departments) released the Federal Independent Dispute Resolution (IDR) Process Administrative Fee and Certified IDR Entity Fee Ranges proposed rule. The rule proposes fee rates for the Federal IDR process under the No Surprises Act (NSA), which was enacted as part of the Consolidated Appropriations Act, 2021 (CAA). A recent court order vacated portions of the previous guidance that the Departments used to establish the administrative fee amount for the Federal IDR process for disputes initiated during the calendar year beginning January 1, 2023. As a result, the Departments are proposing to amend existing regulations to provide that the administrative fee charged by the Departments to participate in the Federal IDR process, and the ranges for certified IDR entity fees for single and batched determinations, will be established by the Departments in notice and comment rulemaking, rather than in guidance published annually.
This proposed rule would also set forth the methodology used to calculate the administrative fee and the considerations used to develop the certified IDR entity fee ranges. In addition, this proposed rule sets forth the amount of the administrative fee and the certified IDR entity fee ranges for disputes initiated on or after the later of the effective date of this rule or January 1, 2024. Based on this proposed methodology, the Departments propose an administrative fee amount of $150 per party for disputes initiated on or after the later of the effective date of this rule or January 1, 2024. For disputes initiated on or after the later of the effective date of this rule or January 1, 2024, the Departments propose a certified IDR entity fee range of $200-$840 for single determinations and $268-$1,173 for batched determinations. Further, for batched determinations exceeding 25 dispute line items, the Departments propose that certified IDR entities may set a fixed fee within the range of $75-$250 for each increment of 25 dispute line items included in the batched dispute. View the proposed rule here.
