Oct. 8, 2021

Federal Government Releases Interim Final Rules for Independent Dispute Resolution, Surprise Billing

On Thursday, Sept. 30, the Biden administration released an interim final rule implementing certain provisions of the No Surprises Act, which was enacted as part of the Consolidated Appropriations Act of 2021 (CAA).

Topics include:

• Independent Dispute Resolution process between insurance issues or plans and providers
• External review process relating to surprise billing
• Dispute resolution process between providers and self-pay or uninsured patients

What this means. We are evaluating the interim final rule to determine how it may affect our implementation work if finalized as currently written. The interim final rule implements portions of the No Surprises Act, which is generally effective for plan or policy years beginning on or after Jan. 1, 2022.

The interim final rules come from the Office of Personnel Management, Internal Revenue Service, Department of the Treasury; Employee Benefits Security Administration, Department of Labor; Centers for Medicare & Medicaid Services; and Department of Health and Human Services.

While we are providing this information regarding key aspects of the CAA, we do not provide groups with legal or compliance advice. Group customers must contact their legal advisors if they have questions about the proposed rules and the new regulations, what they will require and how they will affect their benefit plans if finalized.