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ARTICLE · 19 OCTOBER 2023

Benefits Counselor - October 2023

Reinhart, Boerner, Van Deuren SC
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In August 2023, portions of the independent dispute resolution (IDR) process created by the No Surprises Act were suspended. Since then, a proposed rule has been issued regarding administrative...

United StatesEmployment and HR
Employee Benefits Group
Employee Benefits Group
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HEALTH AND WELFARE PLAN DEVELOPMENTS

Another Eventful Month for the No Surprises Act's Independent Dispute Resolution Process

In August 2023, portions of the independent dispute resolution (IDR) process created by the No Surprises Act were suspended. Since then, a proposed rule has been issued regarding administrative fees, the IDR process has partially reopened, and several pieces of related guidance have been issued.

As a reminder, on August 3, 2023, in Texas Medical Association v. HHS IV (TMA IV), a U.S. District Court Judge in the Eastern District of Texas addressed claim "batching" and the administrative fee required to initiate the IDR process. The Court issued an order vacating the administrative fee increase from $50 to $350 and the prohibition on bundling similar claims. The Court held that the rule violated the Administrative Procedure Act (APA) because it was issued without a notice and comment period and found the rule to be arbitrary

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