For publication in the May 5, 2011 Federal Register, text relating to proposed rules to implement a hospital readmissions reduction program and related quality data reporting measures; part of the CMS Proposed Changes to the Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2012 Rates.
On August 26, 2010, the Departments of Treasury, Labor, and Health and Human Services published in the Federal Register an announcement of the availability of EBSA Technical Release No. 2010-01 providing an interim enforcement safe harbor for non-grandfathered self-insured group health plans not subject to a state external review process and, therefore, subject to the federal external review process.
Group health plans and health insurance issuers offering group or individual health insurance coverage are required to implement internal and external claims appeals processes for appeals of coverage determinations and claims.
Group health plans that currently offer some level of mental health or substance use coverage need to be aware of some significant federal law changes that will take effect in October 2009.