CMS puts No Surprises Act payment determinations on hold after court loss

CMS is instructing certified independent dispute resolution entities to hold all payment determinations under the No Surprises Act until HHS and the Treasury Department issue further guidance. 

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The request comes after a federal judge in Texas ruled Feb. 6 that the No Surprises Act’s revised arbitration process “continues to place a thumb on the scale” in favor of insurers and “that the challenged portions of the final rule are unlawful and must be set aside.”

CMS said in a Feb. 10 letter that the departments are evaluating and updating the IDR process guidance, systems and related documents to make them consistent with the court’s decision. 

IDR entities should also recall any payment determinations after Feb. 6, the letter stated. 

“Certified IDR entities should continue working through other parts of the IDR process as they wait for additional direction from the departments,” CMS said in the letter. 

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