Friday, December 16, 2011
This webinar is brought to you by the Payors, Plans, and Managed Care Practice Group.
Note: This webinar has moved from its originally scheduled time from 1:00-2:30 pm to 2:00-3:30 pm.
Note: If you have any questions for the presenters before/during the webinar, please submit those to the Practice Groups Staff.
The Patient Protection and Affordable Care Act (ACA) includes new requirements for health plans with respect to internal claims and appeals and external review. Payors, including both insured and self-insured health plans, providers, and healthcare consumers, will want to understand the ACA requirements and how they differ for grandfathered and non-grandfathered plans. This webinar will discuss the basics of the U.S. Department of Labor’s internal claims and appeals regulations for both insured and self-insured group health plans, key changes to regulations governing internal claims and appeals, and implementation of the external review process.
Covered topics include: health plans impacted; rescissions as adverse benefit determinations; expanded notice content and claimant rights, including non-English language notices; denials for which external review is available; enforcement guidance; and the 2010 interim final rule versus the 2011 amendments.