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CMS issues new No Surprises Act FAQs

CMS issued two new FAQ documents on the NSA’s independent dispute resolution process (available here and here). The agency clarified that the language of the NSA and non-vacated guidance will govern the disputes until there is new rulemaking. The NSA says items or services may be considered jointly as part of a single determination only if they are “related to the treatment of a similar condition.” CMS did not expand on what that phrase means but said that the IDR entities have the sole responsibility for determining whether a batched dispute meets the remaining regulatory and statutory standards.

Published December 8, 2023