Regulation
What changed in the 2026 Federal IDR Operations Rule
By Verdict Consulting Group ResearchUpdated 3 min read
Short answer
The Federal Independent Dispute Resolution Operations rule, published at 91 FR 33900 on June 4, 2026 and effective August 3, 2026, revises how No Surprises Act IDR runs. It cuts the administrative fee to $15, caps batches at 50 line items, adds CARC/RARC remittance codes and plan registration, and rewrites open negotiation. Provisions apply on staggered dates. A correction followed August 28, 2026.
The rule at a glance
| Item | Detail |
|---|---|
| Title | Federal Independent Dispute Resolution Operations |
| Federal Register citation | 91 FR 33900 (FR Doc. 2026-11140) |
| Published | June 4, 2026 |
| Effective | August 3, 2026 |
| Correction | 91 FR 55462 (FR Doc. 2026-17622), August 28, 2026 |
| Identifiers | CMS-9897-F; TD 10049 |
| Agencies | OPM; Treasury (IRS); Labor (EBSA); HHS (CMS) |
| Proposed rule | 88 FR 75744 (November 3, 2023) |
What the rule changes
- Claim codes. Plans and issuers must use CARCs and RARCs specified in guidance on any paper or electronic remittance advice to an entity with no contractual relationship, to show whether an item or service is subject to the surprise-billing and IDR provisions.
- Payment disclosures. New content with the initial payment or denial, including the plan's legal name and IDR registration number, and revised QPA disclosures.
- Open negotiation. Notices go through the federal IDR system, the open negotiation notice has new required content, and a response notice is due by the 15th business day. The period stays 30 business days.
- Batching. Three permitted batching categories and a limit of 50 line items per batched dispute.
- Eligibility review. Certified IDR entities must determine eligibility within 5 business days of final selection, and parties must answer information requests within 5 business days.
- Fees. The administrative fee falls from $115 to $15 per party per dispute. Certified IDR entity fee ranges of $200–$840 (single) and $268–$1,173 (batched) are codified, with a $75–$250 tiered fee per additional 25 batched line items.
- Registration. Plans and issuers must register in the federal IDR system and receive an IDR registration number.
When each provision applies
The effective date is not the date most provisions start to bite. CMS's August 7, 2026 implementation guide sets out the schedule:
| Provision | Applicability |
|---|---|
| $15 administrative fee | Disputes initiated on or after June 11, 2026 |
| Bundled payment definition; QPA disclosures; certified IDR entity fee procedures | August 3, 2026 |
| All batching provisions, including the 50-line-item limit and batched cooling-off | Open negotiation periods beginning on or after November 1, 2026 |
| CARC/RARC requirement | Items and services furnished on or after January 1, 2027 (guidance issued July 17, 2026) |
| Open negotiation, initiation, entity selection, withdrawals, extensions | Open negotiation periods beginning 90 calendar days after the Departments announce IDR Gateway functionality |
| IDR Registry | Registration due 90 business days after the registry functionality is announced |
CMS expects to roll out the IDR Gateway functions supporting these provisions in spring 2027. Until a provision applies, the existing rules continue to govern.
The problem the rule responds to
The preamble reports that disputing parties had submitted more than 5.1 million disputes as of January 31, 2026, against a first-year expectation of about 22,000 (91 FR 33901–33902). From April 15, 2022 to December 31, 2024, non-initiating parties challenged the eligibility of 976,721 disputes and certified IDR entities found 355,804 ineligible (91 FR 33902).
Correction (2026-10-10): An earlier version said the August 3, 2026 effective date divides disputes into two regimes. Most provisions apply on separate dates, listed above. We also added the correction's citation, 91 FR 55462.
Frequently asked
When did the Federal IDR Operations Rule take effect?
August 3, 2026. The final rule was published in the Federal Register at 91 FR 33900 on June 4, 2026. Many provisions apply on later dates.
Has the Federal IDR Operations Rule been corrected?
Yes. A correcting amendment at 91 FR 55462, published and effective August 28, 2026, fixes typographical errors and omissions in the regulation text. The corrections apply beginning August 3, 2026.
What are the rule's document identifiers?
CMS-9897-F (HHS) and TD 10049 (Treasury). The correction carries CMS-9897-F2.
Related questions
- What is the Federal IDR Operations Rule?
- What are the federal IDR administrative and certified IDR entity fees in 2026?
- Can federal IDR disputes be batched?
- What is the CARC/RARC requirement in the 2026 Federal IDR Operations rule?
- What is the federal IDR Gateway?
- What is the open negotiation period in the No Surprises Act?
- How many IDR disputes have been filed?
Sources
- Federal Register — Federal Independent Dispute Resolution Operations, 91 FR 33900 ()
- Federal Register — Federal Independent Dispute Resolution Operations; Correction, 91 FR 55462 ()
- Centers for Medicare & Medicaid Services — Federal IDR Operations Final Rules Implementation Timeline Guide for Certified IDR Entities and Disputing Parties ()
- Centers for Medicare & Medicaid Services — Federal Independent Dispute Resolution Operations Final Rule — Fact Sheet ()
General information only, not legal advice. Verdict Consulting Group is not a law firm.