Background

As of 12/15/2023, disputing parties were able to initiate batched disputes and air ambulance disputes to the Federal IDR portal. Parties for whom the IDR initiation deadline fell on any date between 08/03/2023 and 03/14/2024 had until the 60th-business day after 12/15/2023, which was 03/14/2024, to initiate batched disputes and air ambulance disputes. However, as of March 15, 2024, the extension period has ended.

1. As of 3/15/2024, the initiation extensions have ended.
   1. Disputes initiated on or after 3/15/2024 will follow normal Federal IDR process timelines.
   2. Disputing parties will generally have 4 business days from the conclusion of their open negotiation period to submit a Notice of IDR Initiation, unless the dispute qualifies for an exception, such as the dispute being subject to the 90-day cooling off period, the dispute having received prior approval for an extension, or an IDRE has requested the party to resubmit the dispute.
2. As of 3/15/2024, the IDRE Selection extensions are no longer available.
   1. Disputes initiated on or after 3/15/2024 will follow normal Federal IDR process timelines.
   2. Disputing parties will have 3 business days from the date of IDR Initiation to jointly select a certified IDR entity. If parties do not come to an agreement within that time period, the Departments will randomly assign a certified IDR entity.
3. As of 3/15/2024, the offer extensions are no longer available.
   1. Disputes initiated on or after 3/15/2024 will follow normal Federal IDR process timelines.
   2. Disputing parties have 10 business days from the date of request to complete the Notice of Offer web form and submit payment of BOTH the administrative fee and certified IDR entity fee to your assigned certified IDR entity.

Extension of Time Periods for Extenuating Circumstances

Although extensions have ended, the Departments (at their discretion) still allows extensions under extenuating circumstances.

• What qualifies as “extenuating circumstances” for an extension: The Departments may extend time periods if the extension is necessary to address delays due to matters beyond the control of the parties or for good cause. Such an extension may be necessary if, for example, a natural disaster or high dispute volume impedes efforts by plans, providers, facilities, and providers of air ambulance services to comply with time-period requirements.
• How to request an extension: Extensions are provided on a case-by-case basis. Parties may request an extension, and provide applicable attestations, by emailing FederalIDRQuestions@cms.hhs.gov with the subject line: Request for Extension due to Extenuating Circumstances, and including an explanation about the extenuating circumstances that require an extension and why the extension is needed.
• When to request an extension: A request for an extension must be filed as soon as administratively practicable following the event that has resulted in the need for the applicable extension. The request for an extension can be filed at any time, either before or after a deadline, and the Departments will consider the request and may grant the extension. However, requesting an extension does not stop the Federal IDR Process, and all of its timelines continue to apply unless and until an extension is granted, so the parties should continue to meet deadlines to the extent possible, until an extension is granted.

The Departments may also provide for extensions in guidance, due to extenuating circumstances. Information on these extensions may be found at https://www.dol.gov/agencies/ebsa/laws-and-regulations/laws/no-surprises-act and https://www.cms.gov/nosurprises.