New Data On Surprises Act: Most Winning Offers Higher Than QPA

By Amy Lotven / July 2, 2024 at 7:07 PM
Recently unveiled CMS data on the federal independent dispute resolution (IDR) process established by the No Surprises Act show that in the second half of 2023 -- like in the first two quarters of the year -- providers won most fights over reimbursement and the payment determinations were much higher than the qualifying payment amount (QPA) or median in-network rate for a service. The QPA is one factor that IDRE entities must consider when determining the winner of a dispute...

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