On April 27, 2023, The Departments of Health and Human Services (HHS), Labor, and the Treasury (the Departments) released a status update on the Federal Independent Dispute Resolution (IDR) Process, which covers the period from April 15, 2022 through March 31, 2023, as well as the initial report on the fourth quarter of 2022. Below are some of the key statistics shared.
Status Update
- Between April 15, 2022 and March 31, 2023, 334,828 disputes were initiated through the Federal IDR portal. This caseload is 14 times greater than what the Departments initially anticipated.
- Non-initiating parties challenged the eligibility of 122,781 of the disputes and nearly 40,000 were deemed ineligible and closed.
- IDR entities have rendered payment determinations in 42,158 disputes to date.
- Initiating parties have been the prevailing party in ~71% of the disputes.
Fourth Quarter Report
- During Q4 2022, disputing parties initiated 110,034 disputes through the Federal IDR process. This represented a 53% increase over Q3.
- IDR entities made over three times more payment determinations in Q4 compared to Q3. IDR entities also closed fewer disputes as ineligible during Q4. Non-initiating parties challenged 40% of the disputes initiated.
- Over two-thirds of the disputes submitted to the Federal IDR portal involved items or services furnished in bifurcated states (i.e., states where some items/services may be subject to a specified state law or All-Payer Model Agreement).
- The report includes a summary of the Top 10 Initiating and Non-Initiating Parties.
- HHS spent $6,646,820 in Q4 to implement and carry out the Federal IDR process; it collected $637,350 in administrative fees.
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