On September 5, the Ways and Means Committee sent a letter to the tri-agencies urging implementation of the No Surprises Act ("NSA"). Specific concerns highlighted in the letter include:

• Patients still did not have access to advanced explanations of benefits ("AEOBs");
• Lack of timely payment following the Independent Dispute Resolution ("IDR") process;
• Rules surrounding claim eligibility and batching created an inefficient IDR process; and
• The calculation of and weight prescribed to the Qualified Payment Amount ("QPA") was inconsistent and unbalanced.

The Committee reiterated the importance of patient access to comprehensive price information for specific medical services consistent with the Administration's prioritization of health care price transparency. 

The Committee specifically requests that the tri-agencies:

• Finalize a clear and consistent QPA calculation methodology;
• Accelerate enforcement of updated QPA calculations;
• Release the statutorily mandated QPA audits to ensure transparency and accountability; and
• Expedite the final rule to ensure an efficient IDR process for all stakeholders.

The Committee's letter puts pressure on the tri-agencies to issue guidance on the QPA, IDR operations, and AEOBs and to step up enforcement.  The IDR operations rule and the AEOB rule are listed on the regulatory agenda for November 2025 and April 2026, respectively.