{"id":115,"date":"2026-05-28T16:49:50","date_gmt":"2026-05-28T16:49:50","guid":{"rendered":"https:\/\/officemovingamerica.com\/?p=115"},"modified":"2026-05-28T16:49:50","modified_gmt":"2026-05-28T16:49:50","slug":"us-hhs-finalizes-rule-to-streamline-dispute-resolution-under-no-surprises-act","status":"publish","type":"post","link":"https:\/\/officemovingamerica.com\/?p=115","title":{"rendered":"US HHS Finalizes Rule to Streamline Dispute Resolution Under No Surprises Act"},"content":{"rendered":"
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May 28 (Reuters) – The U.S. Department of Health \u2060and \u2060Human Services (HHS) on Thursday \u2060finalized a rule to streamline how out-of-network payment disputes \u200bbetween providers and health insurers are resolved, aiming to cut administrative costs.<\/p>\n

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Here are a \u200cfew details:<\/p>\n<\/div>\n

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\u2022 The rule, \u200cpart of a federal law banning surprise medical bills from providers outside \u2060patients’ \u2060insurance networks, aims to reduce ineligible disputes and lowering costs for \u200bproviders and payers.<\/p>\n<\/div>\n

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\u2022 “The No Surprises Act protects patients from unexpected medical bills while creating an arbitration process to resolve certain types of payment disputes between payers and \u200bproviders, and this rule makes significant improvements to the arbitration,” said \u2060Centers for \u2060Medicare & Medicaid Services Administrator \u2060Mehmet \u200bOz.<\/p>\n<\/div>\n

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\u2022 The arbitration happens through the Federal Independent Dispute Resolution process, which the \u200bprovider or insurer can \u2060initiate if they cannot agree on a payment amount for the out-of-network care.<\/p>\n<\/div>\n

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\u2022 The final rule aims to cut administrative fee from $115 to $15 per party per dispute, potentially increasing participation, the agency said.<\/p>\n

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\u2022 It also increases flexibility \u2060in resolving a reasonable number of claims together in a single batch, \u2060reducing costs while speeding up decisions, HHS said.<\/p>\n<\/div>\n

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\u2022 The rule also requires payers to use standardized claim codes when communicating about out-of-network services, helping providers determine early whether a claim qualifies for the IDR process, reducing ineligible disputes, HHS said.<\/p>\n<\/div>\n

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\u2022 Under the rule, a new centralized platform to manage disputes would launch in phases beginning this year.<\/p>\n<\/div>\n

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\u2022 The No Surprises Act was passed in 2020 \u2060to protect patients from surprise billing, which often arose when patients visited a hospital that was part of their insurance network, but later received a bill from doctors who are not part of \u200bthe same insurance network as the hospital.<\/p>\n

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(Reporting by Mariam Sunny \u200bin Bengaluru; Editing by Joyjeet Das)<\/p>\n<\/div>\n

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Copyright 2026 Thomson Reuters<\/b>.<\/p>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

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