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Independent Dispute Resolution
No Surprises Act Regulations Part II - Independent Dispute Resolution (Webinar)
Articles and Materials
SPBA Spring Meeting Presentation Addresses Challenges and Some Solutions to the IDR Process
IRS Releases Guidance on Calculating 2024 QPA Payments
No Surprises Act Independent Dispute Resolution Process Proposed Rule
Calculating the QPA in the Aftermath of the Texas Medical Association et al. Case
Overview Highlights of the SPBA Spring Meeting Session:
“The No Surprises Act Independent Dispute Resolution Process”
Independent Dispute Resolution: Status Update
H. The No Surprises Act Independent Dispute Resolution Process from the Date of Service to the Decision of the IDR Entity - Scott Bennett
Federal IDR Portal Stakeholder Testing Round Table
Federal Judge Strikes Down Pieces of No Surprises Act Independent Dispute Resolution IFR
SPBA Submits Comment Letter on No Surprises Act Independent Dispute Resolution Process
No Surprises Act and Transparency Effective Date Chart
No Surprises Act Regulations - Part II Released
Official Source Documents
Federal Register: Federal Independent Dispute Resolution Operations
Fact Sheet: No Surprises Act Independent Dispute Resolution Process Proposed Rule
ACA FAQ Part 62 on QPA Post Court Decision in TMA III
Payment Disputes Between Providers and Health Plans
IDR Disputing Parties Guidance for payment determinations made on or after February 6, 2023 for items and services furnished on or after October 25, 2022 for plan years beginning on or after January 1, 2022
Guidance for IDR Entities for payment determinations made on or after February 6, 2023 for items and services furnished on or after October 25, 2022 for plan years beginning on or after January 1, 2022
Webinar
Webinar: New Proposed Federal IDR Process, Court Decision, New FAQ and AI Compliance Tools
Plan Transparency
Articles and Materials
Transparency in Coverage Machine-readable Files FAQ Part 70
Enforcement Relief for Gag Clause Prohibition Compliance Attestation
Departments Issue FAQ 69 on Independent Dispute Resolution and the Gag Clause
CAA HB SB Gag Clause Chart
Gag Clause Prohibition Compliance Attestation User Manual Updated
Machine‑Readable Rx Files Enforcement
TinC 2.0 Complexity and HR 3561 Impact
New Requirements Under CMS' Transparency in Coverage Rule Take Effect January 1, 2024
The CAA Gag Clause Prohibition Attestation
New Requirements Under CMS' Transparency in Coverage Rule Take Effect January 1, 2024
Transparency in Coverage Rules….What is it and What it Requires Part 1
Future Rollout of Federal Guidance Planned
SPBA Transparency Summit - 3rd Session - Video Recording
SPBA Transparency Summit - 2nd Session - Video Recording
SPBA Transparency Summit - 1st Session - Video Recording
Administration Finalizes Transparency in Coverage Rule
SPBA Comments on CMS Transparency in Coverage Proposed Rule
Media Reports on Medical $ Transparency
Escape the Fire (Health Care) Trailer
Sales Tool & Opportunity
Official Source Documents
Gag Clause Prohibition Compliance Attestation Annual Submission Instructions & User Manual 2024
Transparency in Coverage Final Rule
Health Coverage Transparency Proposed Rule 11-2019
HHS Report on Reforming America's Healthcare System Through Choice & Competition
Executive Order on Improving Price and Quality Transparency in American Healthcare to Put Patients First
Surprise Billing
No Surprises Act - First Set of New Regulations (Webinar)
Articles and Materials
Progress Toward Advanced Explanation of Benefits (AEOB) Rulemaking and Implementation
No Surprises Act – Determining Cost-Sharing and Payment Amounts to Providers
National Emergency or Public Health Emergency Declaration
SPBA Reviews the Administration's Executive Order
Future Rollout of Federal Guidance Planned
Administration Releases Interim Final Rule on the No Surprises Act
Advanced Explanation of Benefits in the No Surprises Act
F. New Federal No Surprises Act & Related Transparency Requirements
End of Year Spending and COVID Stimulus Package: A Summary
No Surprises Act - Section by Section Summary
Official Source Documents
HHS Progress-AEOB-Rulemaking-Implementation-1 April 2024
HHS Progress on AEOB Rulemaking Update-2 December-2024
Interim Final Rule - Requirements Related to Surprise Billing Part II
Guidance for IDR Entities for payment determinations made on or after February 6, 2023 for items and services furnished on or after October 25, 2022 for plan years beginning on or after January 1, 2022
Requirements Related to Surprise Billing - Final Rules (8/2022)
Rx Reporting IFR
Surprise Billing Model Notice
Interim Final Rule - Requirements Related to Surprise Billing; Part I
No Surprises Act Bill Text
Hospital Transparency
Articles and Materials
SPBA Meeting with GAO on the Use of Hospital Pricing Information
SPBA Comments on CMS Hospital Transparency Proposed Rule
YOUR Achievement on Hospital Price Transparency
Transparency Documentary Trailer
SPBA Policy Brief on Hospital Transparency (Updated version posted 4/20/12)
Sharing Hospital Transparency
Hospital Transparency
Official Source Documents
Hospital Price Transparency FAQs as of 5/8/2025
Reference-Based Pricing
Articles and Materials
How Montana cut healthcare costs with reference-based pricing
Webinar
Webinar: Reference-Based Pricing