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Federal Independent Dispute Resolution (IDR) Process Guidance for Certified IDR Entities (Revised)

Guidance for certified Federal independent dispute resolution (IDR) entities applicable to all items and services that are furnished on or after October 25, 2022, for plan years (in the individual market, policy years) beginning on or after January 1, 2022, by an out-of-network provider subject to the Requirements Related to Surprise Billing; Part II Interim Final Rules, 86 FR 55980 and Requirements Related to Surprise Billing Final Rules; 87 FR 52618. Revised December 2023.

Download the Guidance Document

Final

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: December 15, 2023

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.