DOL, HHS, and Treasury Finalize Surprise Billing Policies

On August 19, the Departments of Labor, Health and Human Services, and the Treasury issued final rules concerning standards related to the arbitration process implementing the No Surprises Act, a bipartisan law to protect consumers against surprise medical bills. The increased transparency required under these final rules is designed to help providers, facilities and air ambulance providers engage in more meaningful open negotiations with plans and issuers. They will help inform the offers they submit to certified independent entities to resolve claim disputes. Parties or providers (including air ambulance providers), facilities, plans, and issuers may use an arbitration process known as the Independent Dispute Resolution (IDR) process to determine the total payment amount for out-of-network healthcare services for which the act prohibits surprise billing. The final rules include guidance for certified IDR entities on how to make payment determinations and instructs these entities that they must provide additional information and rationale in their written decisions.