More payers and providers are using the independent dispute resolution (IDR) process than the government anticipated to settle payment for items and services covered by the No Surprises Act.
The Office of Inspector General (OIG) recently released its annual report on solutions to reduce fraud, waste, and abuse in HHS programs. In the OIG’s 2022 report, 16 of the top 25 unimplemented recommendations involve CMS, with three relating to Medicare Parts A and B.
CMS released a proposed rule on December 6 to promote transparency, efficiency, and automation in prior authorization processes. Certain requirements in the proposed rule are also intended to improve data accessibility for patients, providers, and payers.
CMS extended enforcement discretion, pending future rulemaking, for providing good faith estimates (GFE) for uninsured or self-pay patients that include price estimates from co-providers or co-facilities. The agency announced the pause in a December 2 FAQ, citing technical limitations.