Federal Regulations

Amendment to Interim Final Rules

Amendments to the July 23, 2010 interim final regulations implementing the requirements regarding internal claims and appeals and external review processes for group health plans and health insurance coverage in the group and individual markets; the rules are intended to respond to feedback from a wide range of stakeholders on the interim final regulations and to assist plans and issuers in coming into full compliance with the law through the implementation process. Jointly published June 24, 2011 in the Federal Register by the Employee Benefits Security Administration, IRS and HHS.

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Federal Agency Guidance

Guidance on External Review for Group Health Plans and Health Insurance Issuers Offering Group and Individual Health Coverage, and Guidance for States on State External Review Processes

June 22, 2011 Technical Release No. 2011-02 from the Employee Benefits Security Administration providing information and guidance on the amendments to the interim rule on internal claims and appeals and external review processes.