No Surprises Act, Consolidated Appropriations Act, 2021

Regulations

Federal Independent Dispute Resolution (IDR)

IDR Operations

The Federal Independent Dispute Resolution (IDR) process helps determine how much a health plan or issuer will pay a provider for out-of-network items and services if there's a disagreement.

IDR Process Admin Fee & Certified Entity Fee Ranges

This rule outlines fees for using the Federal IDR process.

Requirements Related to Surprise Billing

Requirements Related to Surprise Billing, Part II

Prescription Drug and Health Care Spending

Employers and insurance companies must submit details on prescription drugs and health care spending through the RxDC report.

Advanced Explanation of Benefits

Requirements Related to Air Ambulance Services, Agent and Broker Disclosures, and Provider Enforcement

Air ambulance providers, insurance companies, and health plans must provide certain information to the Federal Government.

Requirements Related to Surprise Billing, Part I

This rule implements provisions of the No Surprises Act and restricts surprise billing for patients in job-based and individual health plans who get emergency care, non-emergency care from out-of-network providers at in-network facilities, and air ambulance services from out-of-network providers.