March 17, 2023

Big Advocacy Win: CMS Revises No Surprises Act Guidance

How about some great news on a Friday afternoon? Emergency physicians just scored an important advocacy victory!

On March 17, CMS issued revised guidance for the independent dispute resolution (IDR) process that takes into account the recent Texas Medical Association Court Order.  The new guidance removes the flawed "double counting" provision and states that independent arbiters must consider all evidence presented to them by the disputing parties (without weighting the qualifying payment amount more heavily than any other factor or assuming that other factors are already incorporated into the qualifying payment amount). 

At last, the guidance seems to closely reflect what the No Surprises Act statute actually says. This is a major advancement in ACEP's advocacy push to make the arbitration process more fair and balanced.

After being suspended for services delivered after Oct. 25, 2022, IDR process is now finally reopened for all claims! Hopefully now since the IDR process is reopened, arbiters can start working through the significant backlog.


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