The U.S. Departments of Labor, Health and Human Services, and the Treasury have issued final rules concerning standards related to the arbitration process in implementing the No Surprises Act.
The final rules aim to clarify the process for providers and health insurance companies to resolve their disputes, Heatlhcare Finance reports.
Importantly for hospitals, the final rules reflect a District Court ruling vacating a portion of the October 2021 interim final rules that required Independent Dispute Resolution entities to select the offer closest to the Qualified Payment Amount.
This process favored insurers, hospitals argued.
The District Court vacated this requirement in rulings in February and July.
The final rules specify that certified IDR entities should select the offer that best represents the value of the item or service under dispute after considering the Qualified Payment Amount (QPA) and all permissible information submitted by the parties.
