CMS has halted the arbitration process for “Surprise Billing” established by the “No Surprises Act” for the second time, stating as follows:


“On August 3, 2023, the U.S. District Court for the Eastern District of Texas issued a judgment and order in Texas Medical Association, et al. v. United States Department of Health and Human Services, Case No. 6:23-cv-59-JDK (TMA IV), vacating certain portions of 45 C.F.R. § 149.510, 26 C.F.R. § 54.9816-8T, and 29 C.F.R. § 2590-716-8.  As a result of the TMA IV decision, effective immediately, the Departments have temporarily suspended the Federal IDR process, including the ability to initiate new disputes until the Departments can provide additional instructions.”

The Federal arbitration process for handling out-of-network medical bill disputes has not been operating smoothly or timely.  The primary reason for this is that CMS has received more than 300,000 disputes during the first year of the arbitration process, which is almost 14 times what had been estimated during the rulemaking process. For more information with respect to the problems of surprise medical billing, log into the website of the “Coalition Against Surprise Medical Billing” at this link.