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Surprise Billing Arbitration Rules Set Payment Dispute Bounds (1)

Sept. 30, 2021, 8:47 PMUpdated: Sept. 30, 2021, 10:57 PM

The Biden administration released regulations Thursday specifying how billing disputes will be resolved for emergencies and other types of health care.

The interim final rule (RIN 0938-AU62) from four agencies covers the independent dispute resolution process that health-care providers and health plans must use under the No Surprises Act enacted in 2020 as part of budget legislation (H.R. 133). The rule is the third one issued to implement the law.

The rule details how the total payment to an out-of-network provider or facility will be determined.

The arbitration process was the most hotly debated provision ...