[20220401]IF12073_意外计费：独立争议解决流程.pdf

https:/crsreports.congress.gov April 1, 2022Surprise Billing: Independent Dispute Resolution ProcessThis In Focus summarizes statute and interim final rule (IFR) regulations to describe the independent dispute resolution (IDR) process available to insurers and out-of-network providers in certain surprise medical billing situations. It accounts for IFR aspects invalidated in the Texas Medical Association v. U.S. Department of Health and Human Services decision but predates a federal response to that decision. For more information on surprise billing in general and corresponding consumer protections, see CRS Report R46856, Surprise Billing in Private Health Insurance: Overview of Federal Consumer Protections and Payment for Out-of-Network Services. For more information on the litigation related to the IDR process, see CRS Insight IN11906, No Surprises Acts Independent Dispute Resolution Process and Related Litigation. Surprise Billing In general, surprise billing occurs when consumers are unknowingly, and potentially unavoidably, treated by providers outside of their health insurance plans network. As a result, these consumers unexpectedly receive larger bills than they would have r