Saturday, February 4, 2023
HomeLatest NewsFederal NewsNo Surprises Act Final Rule Released

No Surprises Act Final Rule Released

​The departments of Health and Human Services, Labor and the Treasury issued the No Surprises Act final rule updating several key regulations. Updates include clarifying information certified independent dispute-resolution entities must consider when making a payment determination under the federal arbitration process.

Other updates from the final rules also:

  • Discuss situations in which payers have a down-coded claim.
  • Establish new requirements about what information payers must share with providers if a claim is down-coded.
  • Provide an FAQ and status report for the independent dispute-resolution process.

Recently, the Centers for Medicare & Medicaid Services launched a new webpage with resources and guidance related to the dispute resolution process under the No Surprises Act, including guidance for disputing parties and a walk through of the federal portal.  CMS also has added functionality to the portal for initiating disputes, including a button to upload supporting documents at initiation.

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