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Banning Surprise Bills, Part 1: A New Rule on Independent Dispute Resolution
Health Affairs ForefrontLink to more items from this source
[Guidance Overview]
Oct. 4, 2021

"IDR entities must select the offer that is closest to the qualifying payment amount (i.e., the median in-network rate that payers pay to providers) and only deviate if there is credible information for the need to do so. This will help ensure that IDR outcomes are predictable and that stakeholders are not incentivized to use the federal IDR process to obtain higher out-of-network payments when doing so is not warranted based on the circumstances."

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