No Surprises Act Dispute Resolution Continues During Government Shutdown, CMS Reports
WASHINGTON, D.C. – The Independent Dispute Resolution (IDR) process established under the No Surprises Act remains operational despite the ongoing government shutdown, according to the Centers for Medicare & Medicaid Services (CMS). while standard dispute timelines are currently being maintained, CMS cautioned on October 2nd that a prolonged shutdown “may cause delays in the review and processing of IDR complaints and response times to inquiries.”
The government shutdown began October 1st after Congress failed to agree on a federal spending plan. Politico reported October 6th that October 15th – the date active-duty military members could miss a paycheck – is emerging as a critical deadline for resolving the impasse, as Democratic and Republican leaders continue to disagree on a bill, with the extension of ACA premium tax subsidies being a key sticking point.
Despite the broader budgetary challenges, CMS recently announced significant progress in addressing a ample backlog in IDR disputes. A September 19th agency report revealed that when the IDR portal launched in 2022, it received nearly 14 times the initially projected number of disputes. That volume has since increased to more than 100 times the original estimate.
Over the past year,the Department of Health and Human Services (HHS),along with the Departments of labor and Treasury,have implemented measures to resolve capacity issues and reduce the backlog. Consequently, IDR entities are now resolving disputes at a faster rate than they are being submitted.
As of July, 96.5% of all IDR disputes submitted since the program’s inception have either been resolved or are less than 30 business days old, according to CMS data.
