Anesthesia Denials Alert: Insights from Recent Cases in WI and CA
October 5, 2023OB Series Part 1: Understanding ASA’s Proposed Methods and Payer Requirements
November 2, 2023Effective October 6, 2023, the Departments of Health and Human Services, Labor, and the Treasury have re-opened the Federal Independent Dispute Resolution (IDR) portal for the initiation of certain new single and bundled disputes. On September 21, 2023, the Departments directed certified IDR entities to resume processing all in-progress single and bundled disputes submitted on or before August 3, 2023. The Notice of Initiation webform is now available to disputing parties to initiate new single and bundled non-air ambulance disputes.
The Departments will allow parties impacted by the temporary suspension of the Federal IDR process more time to submit and respond to new disputes.
- Parties for whom the Federal IDR initiation deadline required by regulation falls on a date beginning August 3, 2023, through November 3, 2023, will have until the 20th business day after the Federal IDR portal reopens for new dispute processing, which is November 3, 2023, to initiate a new dispute.
- For new disputes initiated between October 6, 2023, and November 3, 2023, the deadline for certified IDR entity selection will be 10 business days after initiation, and the deadline to submit fees and offers will remain 10 business days after certified IDR entity selection.
- Disputing parties that were engaged in certified IDR entity selection when the Federal IDR portal temporarily closed will have 10 business days from October 6, 2023, to agree on a certified IDR entity.
- All other deadlines under the Federal IDR process remain unchanged.
Still temporarily suspended are the processing of in-progress batched disputes, new batched disputes, and new air ambulance disputes while the Departments update batching and air ambulance guidance and operations to align with the district court’s opinions and orders in TMA III and TMA IV. Disputing parties should continue to engage in open negotiation according to the required timeframes until further notice from the Departments.
Parties should reference the October 2023 NSA IDR Partial Reopening of Dispute Initiation FAQs, October 2023 FAQs about Consolidated Appropriations Act, 2021 Implementation Part 62 (FAQs Part 62), and the August 2023 IDR Administrative Fees FAQs for further information.
For assistance with your anesthesia coding questions, contact the ACE/HANK Team.