HHS Certifies 17th IDR Entity as No Surprises Act Disputes Increase

HHS has certified Physio Solutions (doing business as medlitix) as the 17th independent dispute resolution entity authorized to settle out-of-network payment disputes under the No Surprises Act. The certification comes amid growing volume of surprise billing arbitration cases and increased scrutiny of IDR entities by researchers and lawmakers. The No Surprises Act requires federal certification of dispute resolution entities to adjudicate payment disputes between providers and health plans when patients receive out-of-network emergency or certain facility-based care. The expansion of certified IDR entities affects Medicaid managed care plans that contract with out-of-network providers and face similar surprise billing scenarios under state law or federal Medicaid managed care regulations.

Managed Care