Is the NSA IDR Process Dead?

Congress passed the No Surprises Act (NSA) effective January 1, 2022, establishing an Independent Dispute Resolution (IDR) process that allows noncontracted healthcare providers to challenge payments made by health plans. While many providers have successfully used the IDR process to obtain favorable rulings, ongoing litigation and recent court decisions have created uncertainty about its future and its effectiveness. 

This program will provide an update on the latest legal developments surrounding the IDR process, including: 

• the enforceability of IDR rulings in light of the Supreme Court’s recent refusal to review a Fifth Circuit decision that found that providers could not enforce IDR rulings in court;  
• whether providers are required to use the IDR process to challenge out-of-network underpayments;  
• whether the IDR process is mandatory, and if so whether it is constitutional;   
• if there are specific state laws that allow providers to recover reasonable amounts for out-of-network services; and  
• alternative avenues for noncontracted providers to dispute underpayments. 

For questions, or for information about registration,  contact Sydney Forte.