Health Care Reform Dashboard

Health Care Reform Dashboard

Charting developments on the
Affordable Care Act

Claims, Appeals and External Reviews

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06/27/2011

Amendments Made to Claim and Appeal and External Review Rules

The U.S. Departments of Treasury, Labor, and Health and Human Services have collectively released amended interim final regulations addressing internal claims and appeals and the external claims review requirements under health care reform. The new regulations amend initial claims review guidance issued by the Departments on July 22, 2010. (Click here to read our legal … Continue Reading »
03/22/2011

Government Extends Relief from Certain Claim and Appeal Rules

In a new technical release, the government agencies responsible for implementing various health care reform requirements (the U.S. Departments of Labor, the Treasury, and Health and Human Services) have extended the reprieve that they previously granted with respect to certain rules affecting health benefit claims and appeals. Last year, these agencies announced that they would … Continue Reading »
10/12/2010

IRS Delays Reporting of Group Health Plan Cost on Form W-2

Today, the IRS released Notice 2010-62, which provides that employers will not be required to report the cost of group health plan coverage on Form W-2 issued for 2011. Employers will welcome this notice, which will allow them additional time to modify their payroll systems and procedures to address this new health care reform reporting … Continue Reading »
09/23/2010

New Guidance on Health Care Reform

The three federal agencies that have published regulations on health care reform provisions (U.S. Departments of Treasury, Labor, and Health and Human Services) have furnished additional guidance on certain issues of particular importance to employers and other group health plan sponsors. A new set of Frequently Asked Questions and Answers addresses specific questions that many … Continue Reading »
08/26/2010

Additional External Claims Review Guidance Provided for Self-Funded Group Health Plans

The U.S. Departments of Treasury, Labor, and Health and Human Services have released guidance on how employer-sponsored self-funded group health plans can satisfy the new external claims review requirements arising from the federal health care reform legislation. The new guidance, which supplements initial claims review guidance issued by the Departments on July 22, 2010, is … Continue Reading »
07/26/2010

New Regulations Address Claim and Appeal Processes under Health Care Reform

The recent health care reform legislation requires a group health plan to maintain an internal claim and appeal process that meets certain standards and to provide for an external appeal process. The U.S. Departments of Treasury, Labor, and Health and Human Services have jointly released regulations that address these subjects. Internal Claims and Appeals The … Continue Reading »
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