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New Health Plan Appeals Rules Announced by HHS

Click here to read the HHS fact sheet on the new internal/external appeals rules for NEW health plans. Grandfathered plans are not impacted by the new rules.

The new rules provide health plan members with the ability to appeal denials to an outside, independent decision-maker. The National Association of State Insurance Commissioners is encouraging states to adopt these same appeals procedures. If states do not, members will have these same rights through the Federal regulations. NEW self-insured health plans will be subject to these regulations as will all new individual health policies.

Posted by Cristie Travis at 8:53 AM

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