Federal health officials met with the arbitration companies that settle payment fights between insurers and out-of-network providers, after the system handled far more cases than expected. In an Oct. 2 news alert, the Centers for Medicare & Medicaid Services (CMS) said it had convened leaders of 17 certified independent dispute resolution (IDR) entities with CMS Administrator Dr. Mehmet Oz, Department of Labor Assistant Secretary Daniel Aronowitz, and officials from HHS, Labor, and the Treasury.
For patients, the most important point is that this fight happens behind the scenes, between insurers and providers. The No Surprises Act bars most insured patients from being stuck with the gap between what an out-of-network provider charges and what their plan pays. Billing a patient for that gap is called balance billing, and when it arrives unexpectedly, it is a surprise bill.
