Last Friday, the U.S. Department of Labor (DOL), the Department of Health and Human Services (HHS) and the Department of the Treasury released their interim final rule on the independent dispute resolution process under the federal No Surprises Act (NSA). The NSA dispute resolution process applies to payment disputes between hospitals and providers and insurers for services subject to the NSA’s balance billing prohibitions. The NSA dispute resolution process applies in cases where the enrollee’s insurance is not subject to the state’s Balance Billing Protection Act (BBPA). Under E2SHB 1688 for individuals and groups subject to the BBPA, the state is maintaining a separate panel of arbitrators and process for disputes between hospitals and providers and insurers. This will remain in effect until at least July 1, 2023. More information regarding the BBPA and its relation to the NSA is in our recent bulletin.
The Department of Labor has provided extensive information, including links to the interim final rule and FAQs here. In addition, the Centers for Medicare and Medicaid Services has provided a portal for hospitals and providers to initiate the dispute resolution process and other resources. (Andrew Busz, email@example.com)