Biden Admin Proposes Overhauls to Lambasted Out-of-Network Billing Dispute Resolution Process

Friday’s proposed rule—released jointly by HHS, the Department of Labor, the Department of the Treasury and the Office of Personnel Management—aims to address the criticisms with a slew of new processes and requirements.

Per an HHS fact sheet, the administration is proposing that payers include additional information alongside their initial payments or notices of denials, such as the qualifying payment amount and contact information for initiating the open negotiation period.

This, along with other standardized information, “would facilitate communication between parties prior to and during open negotiation and reduce the number of ineligible payment disputes submitted to the Federal IDR process,” HHS said.

Source: https://www.fiercehealthcare.com/regulatory/biden-admin-proposes-overhauls-lambasted-out-network-billing-dispute-resolution-process