In testimony before the U.S. House Committee on Ways and Means, James L. Bobeck, President of Federal Hearings and Appeals Services Inc. (FHAS), called for the immediate reopening of the case filing portal for the Independent Dispute Resolution (IDR) process under the No Surprises Act.
The No Surprises Act, which took effect in 2022, protects patients from surprise medical bills for out-of-network services. When providers and payers disagree on payment amounts, they can use the IDR process overseen by certified Independent Dispute Resolution Entities (IDREs) like FHAS to determine a final payment.
However, recent federal court rulings vacating certain regulations have led to suspensions of the IDR process by the federal departments overseeing it. This has created a significant backlog, with over 40,000 cases per month unable to be filed during the current suspension that began on August 3rd.
As an experienced IDRE that has adjudicated over 46,000 payment determinations since the law's implementation, FHAS emphasized the vital importance of reopening the IDR portal to resolve billing disputes. Without the ability to finalize payments through the IDR process, providers cannot get paid for services rendered and payers cannot make required payments.
Bobeck testified that the public-private IDRE system is crucial for implementing the No Surprises Act's protections against surprise medical billing. He urged the government to immediately reopen the case filing system to clear the mounting backlog and ensure the IDR process can function as intended.