ERISAclaim.com Press
Release
FOR
IMMEDIATE RELEASE:
The New 2010
Obama Healthcare Reimbursement Law Webinars Announced As ERISA Appeals
Procedures Now Mandatory for All Group Health Plans and Healthcare
Providers 01-04-2010, Hanover Park, IL
The Final Health Bill Passed In Senate
On Christmas Eve Is Completely Consistent With House Health Bill By
Incorporating ERISA Claim Regulation In Its Entirety For All Group
Health Plans Into Obama Health Reform, For 200 Million Americans
Under New Obama Universal Healthcare Laws. ERISA Appeal Process Is
Now Mandatory For All Group Health Plans And Healthcare Providers As
Well As Consumers. First Free Monthly ERISA Webinar starts on
01/18/2010, and First Advanced ERISA Claim Specialist Certification
Program Starts in Feb. 2010.
Hanover Park, IL (PRWEB) Jan. 04, 2010 –
The New 2010 Obama Healthcare Reimbursement Law monthly Webinars and
ERISA Claim Specialist Certification Programs were announced by
ERISAclaim.com because ERISA appeals procedures are now mandatory for
all group health plans and healthcare providers under new Obama
Healthcare Reform Laws.
The final
Managers' Amendment of Senate Health
Bill, HR3590, Patient Protection and Affordable Care Act
added a special section,
Sec. 2719, (a)(2)(A),
to incorporate
ERISA claim regulation, 29 CFR
§2560.503.1 in its entirety
for all group health plans and all health insurance Companies offering
group health coverage. The final Senate Bill is completely consistent
with
House Bill, HR3962, Affordable Health
Care for America Act, which
has the exact same ERISA provision in the
Sec. 232, Requiring Fair Grievance And
Appeals Mechanisms. Therefore,
the new health care reimbursement laws from Obama Healthcare Reform
are completely a done deal from legislation in the making as a matter
of “what”, for all payers and providers. ERISA will be the only
governing federal law for claims denials and appeals procedures for
group health plans after January of 2010 for an additional 30 million
Americans who are otherwise uninsured today. ERISA has been the only
governing federal law for claims denials and appeals procedures for
about
170 million Americans covered under
employment-based health plans
for the past 35 years. The new ERISA appeal provision will be
effective immediately upon the enactment of the Health Bill, and all
group health plans will have 6 months after the enactment of the Act
to come into complete compliance with appeals provisions of the new
Obama federal healthcare laws.
The final Senate Health Bill, HR3590,
Patient Protection and Affordable Care Act
added a special section, Sec. 2719, (a)(2)(A), which provides the
following:
‘‘(2) ESTABLISHED PROCESSES.—To comply
with paragraph (1)—
(A) a group health plan and a health
insurance issuer offering group health coverage shall provide an
internal claims and appeals process that initially incorporates the
claims and appeals procedures (including urgent claims) set forth at
section 2560.503-1 of title 29, Code of Federal Regulations, as
published on November 21, 2000 (65 Fed. Reg. 70256), and shall update
such process in accordance with any standards established by the
Secretary of Labor for such plans and issuers; and”
<http://democrats.senate.gov/reform/managers-amendment.pdf>
The
Sec. 232 (b) of House Bill, HR3962,
Affordable Health Care for America Act,
provides the following:
“Section 232,
Requiring Fair Grievance And Appeals Mechanisms.
(b) Internal Claims and Appeals Process-
Under a qualified health benefits plan the QHBP offering entity shall
provide an internal claims and appeals process that initially
incorporates the claims and appeals procedures (including urgent
claims) set forth at section 2560.503-1 of title 29, Code of Federal
Regulations, as published on November 21, 2000 (65 Fed. Reg. 70246)
and shall update such process in accordance with any standards that
the Commissioner may establish.”
< http://thomas.loc.gov/cgi-bin/query/z?c111:H.R.3962.pcs:>
ERISA Claim Regulation, the section
2560.503-1 of title 29, Code of Federal Regulations, as published on
November 21, 2000, can be found on the Website of Department of Labor,
DOL:
< http://www.dol.gov/ebsa/regs/fedreg/final/2000029766.htm>
As stated by Robert Gibbs at his White
House Press Briefing on December 22, 2009, “health care reform is not
a matter of if; health care reform now is a matter of when”. It is
widely reported that President Obama is expected to sign the merged
Senate and House final bill into the law before he delivers the State
of the Union address in mid-January 2010.
After the New Year, as soon as Congress
begins the task of merging the Senate Bill with the House Bill for
Obama’s signature, the Congress and the main stream media will be busy
in explaining to the American people how the new Obama Health Reform
would affect people who already have health coverage through
employment-based plans and also people who are not otherwise insured
today, and who will really be responsible for paying for the universal
coverage.
“But, no one is talking about the real
important enforcement issues, as the new solution in Obama Health
Reform, for ERISA claims and appeals process as the final step of
health care delivery, for about 200 million Americans”, said Dr. Jin
Zhou, the president of ERISAclaim.com, the nation’s leading expert in
ERISA claims appeals.
“We must realize that whether the entire
U. S. healthcare delivery system under Obama Health Reform will
succeed or fail finally depending upon whether the new universal care
can or will be paid for, properly to the healthcare providers by the
health plans and insurance companies, or the claims disputes can be
resolved effectively under the new Obama Health Reform with ERISA
appeals procedures”, as explained by Dr. Jin Zhou of ERISAclaim.com.
ERISA appeals procedures were claimed as
one of the health insurance reform solutions by the White House Office
of Health Reform, as posted in
The White House Blog, Where the Road to
Health Reform Began, on
December 29, 2009 at 11:05 AM EST:
“Health Insurance Reform Solution: Reform
will end insurer abuses, lower premiums, and hold insurance companies
accountable…….And consumer rights will be enhanced by requiring all
insurers to provide effective appeals procedures including outside,
independent review of appeals.”
"Entrepreneurs will benefit. Patients and
survivors of diseases will benefit. Americans of different backgrounds
and ethnicities will benefit," as Senate Majority Leader Harry Reid of
Nevada said last month.
Dr. Zhou
further stated that “entrepreneurs from health plans and
healthcare providers must now comply with and master ERISA claim
regulations in order to benefit under the new healthcare legal and
market environment, to either get paid or contain the costs
legitimately.”
In the past 10 years in USA,
ERISAclaim.com has been the only ERISA Specialized Company offering
the most practical and comprehensive ERISA education, consulting and
publishing services for healthcare providers in administrative ERISA
appeals for real problem oriented denials under the most mysterious
35-year-old federal law, ERISA.
For more information or to arrange an
interview, please visit http://www.erisaclaim.com/certification.htm,
or contact Dr. Jin Zhou, president of ERISAclaim.com, at 630-808-7237.
###
Contract:
Jin Zhou,
President
ERISAclaim.com
Tel:
630-808-7237 (Mobile)
Tel:
630-736-2974 (Office)
Fax:
630-736-1439
E-mail:
ERISAclaim@aol.com
website:
http://www.ERISAclaim.com
Related Press Release links:
ERISAclaim.com
Announced The Nation's First Embezzlement Recovery Services for Large
ERISA Health Plans from the $6 Trillion Healthcare Denial Management
Market 10-23-2009, Hanover Park, IL
ERISAclaim.com Announced Free ERISA Webinar for Healthcare Overpayment
Dispute and Claim Denials in Response to Increasing High Demand from
the $6 Trillion Healthcare Denial Management Market
10-19-2009, Hanover Park, IL
ERISAclaim.com Announced the Expansion of Its ERISA Litigation Support
For the Healthcare Claims In Response to Increasing High Demand from
the $6 Trillion Healthcare Denial Management Market.
10-19-2009, Hanover Park, IL
ERISAclaim.com
Announced 2010 ERISA Seminars for Healthcare Overpayment and Claim
Denial Appeals for the $6 Trillion Healthcare Denial Management
Market.
10-14-2009, Hanover Park, IL
ERISAclaim.com
Announced the Nation's First Certification Program for the ERISA
Claim Appeal Specialist for Healthcare Providers and Managed-Care
Payers,
10-13-2009, Hanover Park, IL
Interactive Side-By-Side
Health Reform Comparison Tool of Major Proposals
(Kaiser Family Foundation)
Excerpt: "The Foundation has updated its health
reform resources to reflect provisions of the Affordable Health Care for
America Act (HR 3962) as passed on Saturday by the U.S. House of
Representatives."
Information updated 03/26/2010
