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Agencies Propose Rules to Implement No Surprises Act Federal Independent Dispute Resolution Process
K&L Gates Link to more items from this source
[Guidance Overview]
Oct. 29, 2021

"[The qualifying payment amount (QPA)] will generally be a payor's median in-network rate for: (a) the same or similar services, (b) furnished in the same or a similar facility, (c) by a provider of the same or similar specialty, (d) in the same or similar geographic area.... [T]he QPA is now the presumptive out-of-network rate that an IDR entity must select absent credible evidence that the payor's QPA would be inappropriate under the circumstances."

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