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团体健康计划和健康保险发行人：与内部理赔和申诉以及外部审查程序相关的规则。对暂行最终规则的修订并征求意见。

Group health plans and health insurance issuers: rules relating to internal claims and appeals and external review processes. Amendment to interim final rules with request for comments.

出版信息

Fed Regist. 2011 Jun 24;76(122):37208-34.

PMID:21736162
Abstract

This document contains amendments to 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 provisions of the Affordable Care Act. These 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 an orderly and expeditious implementation process.

摘要

本文件包含对暂行最终法规的修订，这些法规是根据《平价医疗法案》的规定，针对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及外部审查程序的要求而实施的。这些规则旨在回应广泛利益相关者对暂行最终法规的反馈，并通过有序且迅速的实施过程，协助计划和保险公司全面遵守法律。

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