No Surprises Act IDR Portal Reopens to all Disputes as of December 15th

On December 15, 2023, the Federal Departments reopened the Federal Independent Dispute Resolution (IDR) portal to process all dispute types, including previously initiated batched disputes, and new batched disputes.

ASA strongly pushed for the portal to open and avoid any further delays that hurt anesthesia practices. ASA will continue to push for expansion of the batching rules and for timely payments from payers for physicians who prevail in the IDR process. In the meantime, the Departments are granting extensions of the applicable IDR deadlines for the initiation of new batched disputes, resubmission of disputes determined by IDR entities to be improperly batched, and selection or reselection of an IDR entity. Here are the details:

• Parties for whom the IDR initiation deadline under applicable regulations fell on any date between August 3, 2023, and December 15, 2023, will have until the 20th business day after the Federal IDR portal reopens, which is January 16, 2024, to initiate a new batched dispute or a new single dispute involving air ambulance services. Parties for whom the IDR initiation deadline falls between December 16, 2023, and January 15, 2024, will also have until January 16, 2024, to initiate a batched or air ambulance dispute. Parties whose initiation deadline falls on January 16, 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.
• For batched disputes initiated under extensions of deadlines after the Federal IDR portal reopens, the deadline for the parties to jointly select an IDR entity will be 10 business days after initiation.
• For disputing parties that were engaged in IDR entity selection for batched disputes when the Federal IDR portal temporarily closed, the deadline for parties to jointly select an IDR entity will be 10 business days after the Federal IDR portal reopens, which is December 29, 2023.
• An initiating party that has received a notification from an IDR entity that a dispute initiated before August 3, 2023, was improperly batched will have one opportunity to resubmit the improperly batched items and services for reconsideration within 10 business days of being notified by the IDR entity, provided that the initiating party’s 4-business-day period to resubmit the batched dispute expired between August 3 and August 9, 2023.
• The deadline to submit fees and offers will remain 10 business days after IDR entity selection.
• Disputing parties with batched disputes that were impacted by the temporary suspension of use of the notice of offer form will be granted an additional 10 business days to submit offers, as communicated to impacted disputing parties by email from the Federal IDR Inbox.

In addition, on November 22, 2023, the Departments granted extensions in the following circumstances:

• Disputing parties may request additional time, beyond the current business day deadline, to respond to the IDR entity’s requests for additional information. The Departments instructed IDR entities to grant such requests through January 16, 2024.
• IDR entities may provide parties, upon request, an additional 10 business days after the original offer deadline to submit an offer. IDR entities may provide parties this additional time, as needed, through January 16, 2024.

On November 29, 2023, the Departments also announced another extension of the timeline for disputing parties to select an IDR entity:

• Disputing parties will have 10 business days to select an IDR entity for all disputes through January 16, 2024. This extension is automatic and does not require a request by disputing parties.

The Departments also reemphasized that the November 22, 2023, and November 29, 2023, extensions until January 16, 2023, for new single and bundled disputes will persist for all disputes until January 16, 2024.

Reference the most up-to-date resources:
No Surprises Act (NSA) Independent Dispute Resolution (IDR) Batching and Air Ambulance Policy Frequently Asked Questions (FAQs). 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) 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) This contains clarifications on the QPA due to the TMA III lawsuit ruling.
August 2023 IDR Administrative Fees FAQs 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].

IDR TIP- CLEAR YOUR CACHE
If you have initiated a Federal IDR dispute previously, clear your computer’s cache or open the Federal IDR initiation web forms in a private or incognito window to see all the new features. Do this at least once a week to ensure you see the most up-to-date version of the initiation form. Failure to clear your cache or open this form in private/incognito mode could result in additional follow-up with certified IDR entities or system errors.