The Centers for Medicare and Medicaid (CMS) released instructions via their website for entities wishing to apply as a certified independent dispute resolution (IDR) entity. The IDR process, a product of the Consolidated Appropriations Act (CAA), is no joking matter. It is complex, requiring only Plans and Providers to negotiate disputed service fees, removing Plan participants from the fray. To learn more about the CAA’s IDR process, read our blog.
Applying entities must meet the minimum qualification standards; if so, they will proceed to the public petition period. A list of eligible entities will be posted weekly, and will remain open for petitions for 5 business days. Excerpts from CMS’ website are below:
How to submit a petition
Members of the public, providers, facilities, providers of air ambulance services, plans or issuers, and state regulators can petition for the denial of the certification of an IDR entity.
Note: Petitions must be submitted during the 5-day petition window for applicants on that week’s list. After that week, feedback for those applicants closes, and a new 5-day petition window opens for different applicants.
