The Departments Issue Final IDR Operations Rule

On May 28, 2026, the Departments of Health and Human Services (HHS), Labor (DOL), and the Treasury (collectively, the Departments) and the Office of Personnel Management released a final rule governing “Federal Independent Dispute Resolution Operations” (Final Rule). The Federal Independent Dispute Resolution (IDR) process has been strained by dispute volumes far exceeding original expectations and overwhelmingly favoring provider offers.  These ongoing operational and policy challenges have increased plan and issuer costs and created opportunities for provider windfalls that put significant economic pressures on plans and issuers. The Departments originally proposed the rule in 2023, and stakeholders expected them to act quickly to finalize the rule to improve the processes under the No Surprises Act (NSA). However, since the proposed rule was published, issues with the IDR process have continued to increase and new solutions are needed to address these challenges. Of note, in large