《患者保护与平价医疗法案》中关于团体健康计划和健康保险发行商的内部理赔与申诉以及外部审查程序的暂行最终规则。附征求意见的暂行最终规则。

Interim final rules for group health plans and health insurance issuers relating to internal claims and appeals and external review processes under the Patient Protection and affordable Care Act. Interim final rules with request for comments.

出版信息

Fed Regist. 2010 Jul 23;75(141):43329-64.

Abstract

This document contains 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 under the Patient Protection and Affordable Care Act. The regulations will generally affect health insurance issuers; group health plans; and participants, beneficiaries, and enrollees in health insurance coverage and in group health plans. The regulations provide plans and issuers with guidance necessary to comply with the law.

摘要

本文件包含暂行最终法规，这些法规落实了《患者保护与平价医疗法案》中关于团体健康计划以及团体和个人市场中的健康保险覆盖范围的内部理赔和申诉以及外部审查程序的要求。这些法规通常将影响健康保险发行人、团体健康计划，以及健康保险覆盖范围和团体健康计划的参与者、受益人及参保人。这些法规为计划和发行人提供了遵守法律所需的指导。

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