CMS Reduces Filing Fees for NSA IDR Arbitrations

On August 11, CMS announced that it is reinstating the original non-refundable filing fee amount to $50 for initiating arbitration under the No Surprises Act (NSA) amidst the Federal court order to vacate the 600% filing fee increase levied in January.  For payments disputes initiated on or after August 3, 2023 the fee will revert back from $350 to $50 per party per dispute until such time as the Departments can “take action to set a new administrative fee amount”.

For disputes initiated on or after January 1, 2023, through August 2, 2023 where the administrative filing fee of $350 has been paid, the fee will remain unchanged based on CMS’s Q4 2022 guidance. The TMA IV order does not require a refund for claims processed during this timeframe.

While the Federal departments assert the increase in fee was “due to supplemental data analysis and increasing expenditures in carrying out the Federal IDR process since the development of the prior 2023 guidance,” the TMA contends the substantial increase in fees has dramatically impacted many providers’ ability to seek arbitration.

The court order in the TMA IV case also vacated the batching provision which TMA successfully argued the rule limited the types of claims parties could batch together for consideration in one IDR filing.  As of now all IDR entities have access to Single 2023 disputes regardless of whether administrative filing fees were received. We remain committed to covering the ongoing challenges and regulatory changes that impact out-of-network provider reimbursements.

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