Three Years In, ‘No Surprises’ Gets Mixed Reviews From Providers

More than three years after President Joe Biden signed the federal No Surprises Act (NSA) on medical billing, one key issue still remains with the Federal Independent Dispute Resolution (IDR) process – getting insurers to pay providers after they arbitrate their claims.

“There’s no enforcement mechanism for providers,” Bracewell’s Carrie Douglas told Law360’s Healthcare Authority. “If someone doesn’t pay, they don’t pay. Your revenue cycle is really impacted.”

Providers are also frustrated with what they call onerous deadlines to file and pursue their claims. There’s also a troubling lack of clarity surrounding the actual arbitrators, called certified IDR entities, and how they make their decisions, according to Douglas.