Health Care

HHS lays out surprise billing resolution process in new rule

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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.


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