Health: Internal Claims and Appeals and External Review Procedures
Legislative — proposals, bills and analysis from the 109th and 110th Congresses (2006-present)
Regulatory — administrative rules and information from U.S. offices and agencies
Judicial — current and past court cases and amicus briefs
Press Releases — Council statements and advisories to the news media
See Also — for related information
(Items in italic are available only to Council members.)
Official Source Documents
March 23, 2010 — Patient Protection and Affordable Care Act (PPACA) as enacted and amended by the Health Care and Education Affordability Reconciliation Act
Council Materials
| For legislative items — source documents and council materials — released prior to enactment of PPACA on March 23, 2010, please go to the PPACA Archive Page. |
| Click here for the Council's comprehensive chart highlighting PPACA regulatory developments. |
Official Source Documents
November 17, 2011 — DOL FAQs About Affordable Care Act Implementation Part VII and Mental Health Parity Implementation
June 23, 2011 — Amendment to Interim Final Rule on PPACA Internal Claims and Appeals and External Review Processes
June 23, 2011 — Notice of Proposed Rulemaking on PPACA Internal Claims and Appeals and External Review Processes
June 22, 2011 — DOL/HHS Technical Guidance on PPACA External Review Processes
June 22, 2011— HHS Technical Guidance for Self-Insured Plans on How to Elect a Federal External Review Process
June 22, 2011 — HHS Technical Guidance on Culturally and Linguistically Appropriate Standards under Internal Claims and Appeals and External Review Processes
April 1, 2011 — FAQs on PPACA Implementation Part VI
March 18, 2011 — DOL Technical Release 2011-01: Extension of Non-Enforcement Period Relating to Certain Interim Procedures for Internal Claims and Appeals under PPACA
December 22, 2010 — DOL FAQs About Affordable Care Act Implementation Part V and Mental Health Parity Implementation
November 18, 2010 — Request for Information Regarding PPACA Federal External Review Process
November 1, 2010 — FAQs about the Affordable Care Act Implementation Part IV
October 18, 2010 — FAQS about the Affordable Care Act Implementation Part III
October 8, 2010 — FAQS about the Affordable Care Act Implementation Part II
September 20, 2010 — DOL Technical Release 2010-02: Interim Procedures for Internal Claims and Appeals under the Patient Protection and Affordable Care Act
September 20, 2010 — FAQS about the Affordable Care Act Implementation Part I
September 20, 2010 — Revised Model Notice of Adverse Benefit Determination (Microsoft Word version | PDF version)
August 23, 2010 — Tri-Agency Guidance on PPACA External Review Processes
August 23, 2010 — DOL Technical Release 2010-1: Interim Procedures for PPACA Federal External Review
July 23, 2010 — Interim Final Rule on PPACA Internal Claims and Appeals and External Review Processes
July 23, 2010 — IRS Proposed Regulations by cross-reference to temporary regulations on PPACA Internal Claims and Appeals and External Review Processes
July 22, 20100 — Fact Sheet on PPACA Internal Claims and Appeals and External Review Processes
Council Materials
July 25, 2011 — Council Comment Letter Regarding Amended PPACA Regulations Regarding Claims and Appeals
July 6, 2011 — Summary of PPACA Regulations on Claims and Appeals (Courtesy of Groom Law Group)
December 8, 2010 — Council Comments to HHS Regarding Request for Information Regarding PPACA Federal External Review Process
September 30, 2010 — Council Comment Letter Regarding PPACA Regulations on Internal Claims and Appeals and External Review Processes
September 22, 2010 — Summary of September 20 Regulatory Guidance (Courtesy of Groom Law Group)
August 26, 2010 — Health Care Reform Compliance Presentation Slides: External Review Procedures for Self-Funded Group Health Plans (Courtesy of Proskauer Rose)
August 6, 2010 — PPACA Mandates Chart (Courtesy of Proskauer Rose)
July 29, 2010 — Health Care Reform Compliance Presentation Slides: Internal and External Appeals (Courtesy of Davis & Harman and Groom Law Group)
July 29, 2010 — Summary of PPACA Interim Final Regulations on Internal Claims and Appeals and External Review Processes (Courtesy of Groom Law Group)
Council commends reexamination of PPACA claims & appeals, external review regulations
June 27, 2011
Council welcomes new health care reform guidance
September 21, 2010
Condition Critical: Ten Prescriptions for Reforming Health Care Quality, Cost and Coverage
Health
Health Care Reform (PPACA), General & Misc. Items
- Employer Shared Responsibility
- Market Reforms & Adult Child/Age-26 Coverage
- Preventive Care & Value-Based Design
- Quality Improvement & Delivery Reform
- Essential Benefits
- Tax & Revenue Issues
- Grandfathered Plans
- Claims and Appeals
- Summary of Benefits & Coverage
- Informational Reporting/W2
- Health Insurance Exchanges
- State Innovation
- Medical Loss Ratio & Mini-Med Plans
- Automatic Enrollment
- Wellness Programs
- Accountable Care Organizations
- Non-Discrimination
Consumer-Directed Plans (HSAs/FSAs/HRAs)
Health Information Technology & HIPAA Privacy
Retirement
Defined Contribution/ 401(k) Plan Reform
- Automatic Enrollment
- Investments
- Plan fees
- Taxation of Retirement Plans/Limits
- Funding Reform
- PBGC Deficit & Premiums
- Business Conduct Standards
Retirement Plan Administration
Other Issues
Tax Reform, Deficit Reduction & Federal Budget
- FACTA Issues
- FBAR Issues
- Puerto Rico Plans
- Non-Qualified Deferred Compensation
- Code Section 409(A), 457(A), 162(m) issues
- Say-on-Pay
