Compliance & Audits

CMS Meets IDR Entities on No Surprises Act Disputes

More Than 7 Million Disputes Since 2022 and a New Portal Coming

Rcmaxis Billing & Policy Update  ·  Posted October 7, 2026  ·  Effective: Late 2026 (IDR Gateway portal launch)

CMS and the other departments met with all 17 certified IDR entities after more than 7 million No Surprises Act disputes since April 2022, and said a new IDR Gateway portal will launch in late 2026. No rule changed.

Summary of the Rule or Edit Change

CMS announced that officials from CMS, the Department of Labor, the Department of Health and Human Services and the Treasury met with representatives of the certified independent dispute resolution (IDR) entities under the No Surprises Act. All 17 certified entities took part. The stated purpose was to discuss increasingly high IDR-associated costs affecting the health care system, and ways to improve the federal program.

The topics were ineligible disputes, unclear explanations of how determinations are reached, and delayed or missing payment after an award. CMS reported that more than 7 million disputes have been received and closed since April 2022. The Departments said they'll consider what the entities told them as they look at regulatory and operational options, and they announced that the IDR Gateway, a new version of the Federal IDR Portal, will launch in late 2026.

This was an information-sharing meeting. No rule changed, no fee changed and no deadline changed. But the three problems named in the announcement are the ones providers feel most: disputes filed that were never eligible, determinations without a clear reason and awards that aren't paid on time.

The deadlines you already work under still apply. After a payer's initial payment or denial there's a 30 business day open negotiation period, and a request for IDR has to follow within 4 business days after that period ends. Payment of an award is due within 30 calendar days.

Action Required for Billing Teams

  • Check eligibility before filing. Confirm the claim is subject to the No Surprises Act and that the state doesn't have its own process that applies first. Ineligible disputes are one of the named problems.
  • Keep the calendar tight. Record the open negotiation end date for every disputable claim and an owner for the 4 business day filing window.
  • Document your offer. Save the qualifying payment amount, your offer and the supporting data, so a determination can be traced to the evidence.
  • Track payment after the award. Log the determination date and follow up if payment isn't received within 30 calendar days.
  • Prepare for the new portal. When the IDR Gateway opens, confirm who in your office holds the login and who files.
  • Review your dispute results. Count wins, losses and unpaid awards by payer, and keep the list for contract talks. Our guide to No Surprises Act billing covers the full process.

Verifiable References

  1. CMS. CMS Convenes Certified Independent Dispute Resolution Entity Leaders to Discuss Ways to Improve the Federal Program (news alert, October 2026). cms.gov/newsroom/news-alert/cms-convenes-certified-independent-dispute-resolution-entity-leaders-discuss-ways-improve-federal
  2. CMS. Newsroom. cms.gov/newsroom

Related Resources

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