On December 15th, the Centers for Medicare and Medicaid Services (CMS) announced that it is fully reopening the Federal Independent Dispute Resolution (IDR) portal to all new disputes and for disputes that were eligible to be initiated since the portal was temporarily closed on August 3rd.
CMS closed the IDR portal to new disputes on August 3rd in response to successful legal challenges to how the agency implemented certain parts of the IDR process. CMS closed the portal to new disputes so that it could issue new regulations to bring the IDR process into compliance with the judge’s decision in those lawsuits.
CMS gradually began reopening the portal, allowing single disputes to be initiated earlier this year. CMS is now fully reopening the portal to all disputes (single and batched) effective December 15th. CMS also announced timelines for initiating disputes that could not be initiated when the portal was closed.
Disputes that could not be initiated between August 3, 2023, and December 14, 2023, (the period of temporary suspension of IDR operations) will have 60 days (until March 14, 2024) to initiate a new dispute. This primarily applies to new batched disputes and new single disputes involving air ambulance services. CMS began allowing single disputes for non-air ambulance services earlier this year.
The original December 15th announcement only gave 20 days to initiate those disputes. CMS then published a second announcement on December 21st that provided an extension from 20 to 60 days.
One of the key issues addressed in one of the lawsuits is how CMS increased the non-refundable IDR administrative fee from $50 to $300 for disputes initiated in 2023. After the court ruled against the higher fee, CMS issued a final rule that establishes an IDR fee of $115 for disputes initiated on or after January 22, 2024. For disputes initiated between August 3, 2023, and January 21, 2024, the administrative fee amount is $50 per party per dispute.
CMS also announced the following extensions are now available through March 14, 2024, for all dispute types:
- Disputing parties may request additional time to respond to the certified IDR entity’s requests for additional information.
- Certified IDR entities may provide parties, upon request, an additional 10 business days after the original offer deadline to submit an offer.
- Disputing parties involved in any dispute that is initiated through March 14, 2024, will have 10 business days to jointly select a certified IDR entity for those disputes. This extension will be provided automatically and does not require a request by disputing parties.
CMS is still in the process of updating the Federal IDR portal to reflect these extensions.
ADVOCATE will share additional information with clients and friends as it becomes available on this and other Federal Health Policies.
Kirk Reinitz, President