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Healthcare reform: interim final regulations for internal claims and appeals; external review processes for group health plans and health insurance coverage

  • Proskauer Rose LLP
  • -
  • USA
  • -
  • August 6 2010

Group health plans and health insurance issuers (other than grandfathered health plans, which are discussed here) must begin complying with new internal claims and appeals and external review procedures for plan years commencing on or after September 23, 2010

Rulings, filings and settlements of interest

  • Proskauer Rose LLP
  • -
  • USA
  • -
  • August 6 2010

In Borrero v. United HealthCare of New York, Inc., 2010 WL 2652456 (11th Cir. July 6, 2010), healthcare providers (and their representative organizations) alleged state law claims against United HealthCare for failing to pay them the agreed upon rate contained in the subscriber agreements rate for services