Departments Reopen Comment Period for Proposed Rule on Federal Independent Dispute Resolution Operations; Comments Due February 5

Published October 30, 2023

The Departments of Labor (DOL), Health and Human Services (HHS), the Treasury (collectively, the Departments), and the Office of Personnel Management  issued a document reopening the comment period for the proposed rules entitled ‘‘Federal Independent Dispute Resolution Operations’’ that appeared in the November 3, 2023, issue of the Federal Register.

The comment period for the proposed rules, which closed on January 2, 2024, is reopened from January 22, 2024 to February 5, 2024. 

(Updated January 22, 2024)

The Departments of Labor (DOL), Health and Human Services (HHS), the Treasury (collectively, the Departments), and the Office of Personnel Management issued a proposed rule on certain new requirements for group health plans and health insurance issuers; providers, facilities, and providers of air ambulance services; and certified IDR entities as they relate to the Federal independent dispute resolution (IDR) process under the No Surprises Act (NSA).

The proposed rule addresses specific issues critical to improving the functioning of the Federal IDR process in response to feedback and challenges noted by interested parties. Overall, if finalized, the proposed rule would:
  • Set forth new requirements relating to the disclosure of information that group health plans and health insurance issuers offering group or individual health insurance coverage must include along with the initial payment or notice of denial of payment for certain items and services subject to the surprise billing protections in the No Surprises Act;
  • Require plans and issuers to communicate information by using claim adjustment reason codes (CARCs) and remittance advice remark codes (RARCs), as specified in guidance, when providing any paper or electronic remittance advice to an entity that does not have a contractual relationship with the plan or issuer;
  • Amend certain requirements related to the open negotiation period preceding the Federal IDR process, the initiation of the Federal IDR process, the Federal IDR dispute eligibility review, and the payment and collection of administrative fees and certified IDR entity fees;
  • Define bundled payment arrangements, amend requirements related to batched items and services, and amend the rules for extensions of timeframes due to extenuating circumstances; and
  • Require plans and issuers to register in the Federal IDR portal.

Comments are due January 2, 2024.

Additional Information

Fact Sheet
News Release

(Posted October 30, 2023)