Envision recently submitted comments to enhance the No Surprises Act (NSA) Independent Dispute Resolution (IDR) Operations Proposed Rule. If the rule is finalized, many of the proposed changes to the IDR process will meaningfully improve the law’s implementation and outcomes.

The medical group continues to fully support the patient protections and goals of the NSA. While the law has removed patients from the middle of reimbursement disputes between healthcare providers and health insurers, work remains to implement the law consistent with statutory intent. The flawed implementation has resulted in unique challenges for the provider community while giving health insurers the upper hand. In addition, it has led to a growing backlog of unresolved disputes and significant delays in payments to providers.

The proposed rule by the Departments of Health and Human Services, Labor and Treasury addresses some of the most significant problems with the IDR process. It attempts to reduce the time, effort and complexity of determining the eligibility of disputes, which has contributed to the backlog and payment delays. To learn more, read the Health Affairs article, “A Surprise Benefit of New Billing Dispute Rule: Reducing Administrative Burdens and Waste.”

Envision’s comments strive to contribute constructive solutions that enhance the efficiency and effectiveness of the IDR process. These recommendations focus on safeguarding patients, resolving disputes quickly, minimizing administrative waste and establishing incentives for insurers and providers to engage in fair and sustainable networking arrangements.

While the rule undergoes a thorough review, Envision continues to identify solutions that work for all stakeholders and ensure the NSA is implemented as intended. The leading medical group remains steadfast in improving the nation’s healthcare system and advocating for patients and the clinicians who care for them.