WSHA Comments on No Surprises Act IDR Fees

WSHA will provide comment on a CMS proposed rule that would set filing fees for providers requesting arbitration under the federal No Surprise Act (NSA) Independent Dispute Resolution (IDR) process. The proposed rates are $150 for an individual claim and up to $1,173 for batched claims evaluated as a group that involve the same service, provider, and insurer. CMS is requesting comments by October 26 on the new rate after losing a court decision that determined CMS had not followed the appropriate process in raising the fee from $50 to $350. WSHA plans to comment that the fee should be set at a low rate to not be a barrier to providers and hospitals exercising their right to request arbitration. While the focus is the proposed IDR fee level, WSHA plans to also comment that CMS’ instructions to IDR entities improperly favor carriers and should be revised. WSHA will also comment that carriers and insurer groups that do not have full contracted provider networks should not be able pay a qualifying payment amount based on rates that have not been negotiated. (Andrew Busz, andrewb@wsha.org).