Initial Report On The Independent Dispute Resolution (IDR) Process April 15 – September 30, 2022

The report was released in December 2022 by the Centers for Medicare & Medicaid Services. The report presents statistics about disputes between payers and provider organizations over the reimbursement rates paid for health services delivered by out-of-network (OON) provider organizations. The disputes were submitted by provider organizations, facilities, and providers of air ambulance services, Disputes can be filed against group health plans, health insurance issuers in the group and individual markets, and Federal Employees Health Benefits (FEHB) Program carriers can use to determine the OON rate for applicable items or services after an unsuccessful open negotiation period.  The . . .