Overview
The Department of Health and Human Services ("HHS")
published Part II of the No Surprises Act on September 30, 2021,
which will take effect on January 1, 2022. The new guidance, in
large part, focuses on the independent dispute resolution process
that was briefly mentioned in Part I of the Act. In addition, there
is now guidance on good faith estimate requirements, the
patient-provider dispute resolution processes, and added external
review provisions.1
Federal Independent Dispute Resolution
The federal independent dispute resolution process is limited to
the services under Part I of the Act for which balance billing is
prohibited.
The purpose of the dispute resolution process is for
out-of-network providers and facilities to determine the
out-of-network rate after a conclusion is not made after a 30-day
"open negotiation." This open negotiation period must be
initiated first, and only when it fails can the federal independent
dispute resolution
