Health Insurance Claim Appeal Regulations are issued

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What the heck is health insurance anyway?

 
Last week HHS issued interim regulations on the new claim appeal process under the Patient Protection Affordable care Act.   As one may suspect they add a considerable administrative burden and cost to the operation of all health benefit plans.  Regulations address both internal and external claim reviews.  However, the regulations do not address the external claim appeal process for employer plans that are not subject to State regulation, essentially this is a self-funded employer plan which includes most large employers many of which already employ internal and external review procedures.  HHS says there will be supplemental guidance on external review for these plans.

Here is a Fact Sheet (and promotional piece) from HHS on the new Claim Appeal Regulations.    Here is a good summary of the new rules.  Are you sure that you want to give up grandfathering for your plan?