Further Extension of Deadlines for Federal Independent Dispute Resolution (IDR) Activities

On December 21, 2023, the Federal Departments announced a further extension of deadlines, giving disputing parties additional time to complete certain IDR activities impacted by the temporary suspension of IDR operations due to the rulings from the Texas Medical Association (TMA) III and TMA IV cases. ASA strongly pushed for the extension to allow anesthesia practices enough time for initiation and resubmission of batched claims. Today’s announcement further extends deadlines from those announced on December 15, 2023:

Extension Dates: 

• Parties for whom the IDR initiation deadline under applicable regulations fell on any date between August 3, 2023, and December 14, 2023, (period of temporary suspension of IDR operations) will have until the 60th business day after December 15 (date of Federal IDR portal reopening), which is March 14, 2024, to initiate a new batched dispute.
• Parties for whom the regulatory IDR initiation deadline for a batched or air ambulance dispute falls between December 15, 2023, and March 13, 2024, will also have until March 14, 2024, to initiate such disputes.
• Parties whose initiation deadline falls on March 14, 2024, or after will have the usual 4 business days after the end of the Open Negotiation Period, or if the dispute is subject to the 90-calendar-day suspension period following a payment determination, the usual 30-business-day period, to initiate a batched or air ambulance dispute in the Federal IDR portal. 

The Departments also announced that the following extensions are now available through March 14, 2024, for all dispute types:

• Disputing parties may request additional time to respond to IDR entity’s requests for additional information. 
• IDR entities may provide parties, upon request, an additional 10 business days after the original offer deadline to submit an offer. 
• Disputing parties involved in any dispute that is initiated through March 14, 2024, will have 10 business days to jointly select an IDR entity for those disputes. This extension will be provided automatically and does not require a request from disputing parties.

Applicable Administrative and IDR Entity Fees:

• With respect to the administrative fee for Federal IDR disputes, for disputes initiated between August 3, 2023, and January 21, 2024, the administrative fee amount is $50 per party per dispute.
• On December 21, 2023, the Departments established the new administrative fee amount and IDR entity fee ranges; these are effective starting January 22, 2024. Disputes initiated on or after January 22, 2024, the administrative fee amount is $115 per party per dispute and IDR entity fees for disputes initiated on or after January 22, 2024, may be updated.

Reference the most up-to-date resources:
No Surprises Act (NSA) Independent Dispute Resolution (IDR) Batching and Air Ambulance Policy Frequently Asked Questions (FAQs) (PDF). The primary reference on updated batching rules, as of November 28, 2023.

FAQs about Affordable Care Act and Consolidated Appropriations Act, 2023 Implementation Part 63 (FAQs Part 63) (PDF) Pages 4-6 outline the batching rule updates as a result of rulings in the Texas Medical Association (TMA) IV and TMA III lawsuits.

FAQs about Consolidated Appropriations Act, 2021 Implementation Part 62 (FAQs Part 62) (PDF) This contains clarifications on the QPA due to the TMA III lawsuit ruling.

August 2023 IDR Administrative Fees FAQs (PDF) These are the updated fees as of August 2023.

Updated IDR system job aids and updated guidance documents found on the CMS website.

Lastly, direct any questions to the Federal IDR mailbox at [email protected].