The Biden administration on Thursday laid out the independent dispute resolution process that out-of-network providers and plans can use to settle surprise billing disputes.
The long-awaited rule implements a law passed by Congress last year banning providers from sending surprise bills to patients who unknowingly received out-of-network care.
Providers, facilities, plans and issuers can use the independent dispute resolution process if a payment amount for out-of-network services can not be agreed upon after a 30 day “open negotiation,” according to the interim final rule issued Thursday.
The rule “takes consumers out of the middle of a payment dispute between insurers and providers,” an HHS official told reporters Thursday.
Beginning Thursday, organizations can apply to become certified independent dispute resolution entities.