The No Surprises Act was designed to protect healthcare consumers against surprise billing. For payers, it has made processes more complex, especially relating to ensuring that reasonable and acceptable reimbursements are established and benchmarked by procedure, by provider, and by geography.

On September 30, 2021, the Department of Health and Human Services, the Department of Labor, and the Department of the Treasury along with the Office of Personnel Management released an interim final rule, which further explains requirements related to the Independent Dispute Resolution (IDR) process and Qualified Payment Amounts.

Greg T ...