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Healthcare Revenue Cycle Crisis
Turnaround:
Pre-Payment Review
Delays and Denials – Deemed Denial ERISA Appeals
© JIN ZHOU, President,
ERISAclaim.com
April
19, 2010
New ERISA Appeal Books & Webinars
Announced From ERISAcaim.com To Resuscitate Revenue Cycle Crisis With
Right Federal Law Magic. Providers Are Seemingly Left With No Common
Remedies In Wake Of Financial Debilitating Overpayment Demand And
Recoupment From Payers, An Increasing Number Of Healthcare Providers
Are Also Facing Bankrupting Pre-Payment Review Delays For Up To Over A
Year Of No-Pays And Real Denials, In An Unprecedented U.S. Healthcare
Avatar: No Payment From Insurance Companies But Pay Back To Insurance
Companies By Providers. Once Informed Of Pre-Payment Reviews, All
State Prompt Pay Laws No Longer Apply.
New
ERISA Appeal Books Will provide The
Most Powerful Solutions to the Pre-Payment Review Denials and Appeals
The healthcare providers are seemingly
left with no common remedies
in wake of financial
debilitating overpayment demand and recoupment from payers, and an
increasing number of healthcare providers are also facing bankrupting
pre-payment review delays for up to over a year of no-pays and real
denials, in an unprecedented U.S. Healthcare Avatar: no payment from
insurance companies but pay more back to Insurance Companies by
healthcare providers. Once informed by a payer of pre-payment reviews,
all state prompt pay laws no longer apply,
because
no state laws will ever mandate prompt pay for disputed or non-covered
claims, and state laws do not govern ERISA plans, both self-insured
and fully-insured employment-based health plans.
Practically, many healthcare providers are now left with no meaningful
remedies while hopelessly crying on sinking Pre-payment Review Titanic
for inevitable bankruptcy declaration. New
ERISA Appeal Books &
Webinars have been announced from
ERISAcaim.com to resuscitate revenue cycle crisis with right federal
law magic.
Federal
ERISA pre-empts any and all state laws and managed-care contracts in
all money or benefits dispute with ERISA plans,
and ERISA provides with most powerful remedies for healthcare
providers and insured working Americans: under ERISA
§2560.503-1(f)(2)(iii)(B), all post-service claims under pre-payment
reviews with or without request for additional information must be
decided within 30 with no record request from providers, or within 45
days, including 15 days after receiving the additional records, or the
plan must provide claimant with a valid ERISA EOB, Explanation of
Benefits, for immediate ERISA full and fair appeals for all deemed
denials.
One of the most popular and costly
misconceptions for all providers is turning to the state prompt pay
laws and PPO contracts for remedies when the providers were informed
by payers of pre-payment reviews and were put on Moon Project
schedules. State prompt pay laws are not triggered or no longer
applicable as soon as a payer takes an action to review the claim with
a timely notice within the time lines as provided by the state prompt
pay laws, as common sense will tell you that no state prompt pay laws
will ever mandate for a payment for disputed or non-covered services.
More importantly, no state prompt pay
laws will apply to or govern any ERISA plans, especially self-insured
plans.
U. S. Supreme Court unanimously and
repeatedly ruled that federal law, ERISA, completely pre-empts all
state laws in all benefits dispute with an ERISA plan in all
pre-payment and post-payment benefits reviews, in Aetna v. Davila
in 2004, and ERISA provides no exemptions for plan administrators to
act, to make pre-payment and post-payment review decisions, in
accordance with ERISA and the relevant plan documents, regardless of
SIU’s (Special Investigation Unit) and PPO’s, in Kennedy v. Plan
Administrator for Dupont in 2009.
On March 23, 2010, President Barack Obama signed into
law the Patient Protection and Affordable Care Act, PPACA. Effective
upon the enactment of the PPACA on 03/23/2010, every group health plan
and individual policy issuer must comply with effective internal and
external appeal process by incorporating or adopting ERISA claim
regulation and NIAC External Review Model Act for any claim denials
and overpayment dispute.
effective from March 23, 2010, §2719(a)(1)(A)(C) of PPACA
requires every group health plan and health insurance issuer for
individual coverage to “(A) have in effect an internal claims appeal
process” and “(C)
allow an enrollee to review their file”,
the entire claim case file or administrative file regardless if the
plan is a statutory ERISA plan.
As
one of the healthcare providers who attended ERISAclaim.com Seminars
complained:
“Since we were asked by a payer to pay
back for more than $300,000 as alleged overpayment about 2 years
ago, we have spent more than $60,000 to $70,000 on attorney fees in
a fight over the overpayment demand, at the same time, the payer has
put us on pre-payment reviews for all new claims for more than one
year without any payment at all.”
ERISA §2560.503-1(f)(2)(iii)(B)
Requires Plan To Make A Timely Decision In 45 Days Accordingly
ERISA §2560.503-1(f)(2)(iii)(B) provides in part:
“(f) Timing of notification of benefit
determination…….
(2) Group health plans. In the case of
a group health plan, the plan administrator shall notify a claimant
of the plan's benefit determination in accordance with paragraph
(f)(2)(i), (f)(2)(ii), or (f)(2)(iii) of this section, as
appropriate.
(B) Post-service claims. In the case
of a post-service claim, the plan
administrator shall notify the
claimant, in accordance with paragraph (g)
of this section, of the plan's adverse benefit determination
within a reasonable period of time,
but
not later than 30 days after receipt of the claim.
This period may be extended
one time by the plan
for up to 15 days, provided that
the plan administrator both determines that such an extension is
necessary due to matters beyond the control of the plan and notifies
the claimant, prior to the
expiration of the initial 30-day period, of the circumstances
requiring the extension of time and the date by which the plan
expects to render a decision. If such an extension is necessary due
to a failure of the claimant to submit the information necessary to
decide the claim, the notice of extension shall specifically
describe the required information, and the claimant shall be
afforded at least 45 days
from receipt of the notice within which to provide the specified
information.” (Emphasis added)
<<http://www.dol.gov/ebsa/regs/fedreg/final/2000029766.htm>>
DOL FAQs About The Benefit Claims
Procedure Regulation
< http://www.dol.gov/ebsa/faqs/faq_claims_proc_reg.html>
“C-3: If the period within which a
group health claim must be decided is ending and the claimant has
yet to furnish all the information necessary to decide the claim,
may the plan extend the time period for deciding the claim and,
if so, for how long?
In general, a group health plan may
unilaterally extend the decision making on both pre-service and
post-service claims for 15
days after the expiration of the initial period, if the
administrator determines that such an extension is necessary for
reasons beyond the control of the plan. There is no provision for
extensions in the case of claims involving urgent care.
If the reason for taking the extension
is the failure of the claimant to provide information necessary to
decide the claim, and the claimant is so notified of this fact, the
time period for making the decision is suspended (tolled) from the
date of the notification to the claimant to the earlier of:
· The date on which a response
from the claimant is received by the plan
· The date established by the
plan for the furnishing of the requested information (at least 45
days)
The extension period (15 days) – within
which a decision must be made by the plan – will begin to run from
the date on which the claimant’s response is received by the plan
(without regard to whether
all of the requested information is provided) or, if earlier,
the due date established by the plan for furnishing the requested
information (at least 45
days). See §§ 2560.503-1(f)(2)(iii) (A) and (B);
2560.503-1(f)(4); 2560.503-1(i)(4). Also see 65 FR at 70250, n.21.”
(Emphasis added)
<http://www.dol.gov/ebsa/faqs/faq_claims_proc_reg.html>
DOL ERISA Claims Guidance: Filing A Claim
For Your Health Or Disability Benefits
< http://www.dol.gov/ebsa/publications/filingbenefitsclaim.html>
“Waiting For A Decision On Your
Claim
As noted, ERISA sets
specific periods of time for plans to evaluate your claim and inform
you of the decision. The time limits are counted in calendar
days, so weekends and holidays are included. These limits do not
govern when the benefits must be paid or provided. If you are
entitled to benefits, check your SPD for how and when benefits are
paid. Plans are required to pay or provide benefits within a
reasonable time after a claim is approved.
Post-service health claims
must be decided within a
reasonable period of time, but not later than 30 days after the plan
has received the claim. If, because of reasons beyond the
plan’s control, more time is needed to review your request, the plan
may extend the time period
up to an additional 15 days. However, the plan administrator
has to let you know before
the end of the first 30-day period, explaining the reason for the
delay, requesting any additional information needed, and advising
you when a final decision is expected. If more information is
requested, you have at least 45 days to supply it.
The claim then must be
decided no later than 15 days after you supply the additional
information or the period of time given by the plan to do so ends,
whichever comes first.
The plan needs your consent
if it wants more time after its first extension.
The plan must give you notice that your claim
has been denied in whole or in part (paying less than 100% of the
claim) before the end of the time allotted for the decision.
(Emphasis added)
< http://www.dol.gov/ebsa/publications/filingbenefitsclaim.html>
DOL ERISA Claims Guidance: What You
Should Know About Filing Your Health Benefits Claim
< http://www.dol.gov/ebsa/publications/wyskfhbc.html>
“Obtain A Copy Of Your Summary Plan
Description (Often Referred To As An SPD)
The first step you should take - even
before you are ready to file a benefit claim - is to carefully read
your plan’s summary plan description.
This is a document which
your plan administrator must
furnish to you after you join the plan. You can also request a copy
from your plan administrator. The SPD gives you a detailed
summary of your plan - how it works, what benefits it provides, and
how they may be obtained (the process for filing your claim). The
summary plan description is also required to describe your rights
and protections under ERISA.
Waiting For A Decision On Your Claim
Your plan’s claims procedure should
state the time within which the plan must provide you with a
decision on your claim. Be
sure to look for these in your SPD. When you submit a claim
to your plan, note the date and keep track of the time as you wait
for a decision. Some plans may have different time periods depending
on the nature of the benefit claim - such as whether the claim is
for urgent care and whether the claim is filed before medical care
is received or after. Some plans’ procedures allow the plan to
extend the time period. Your plan’s claims procedure should provide
for the plan’s notification to you of the plan’s decision on your
claim for benefits. If you
do not get a response from your plan within the specified time
period, contact your plan administrator.” (Emphasis added)
< http://www.dol.gov/ebsa/publications/wyskfhbc.html>
United States Supreme Court
unanimously ruled on 06/21/2004 that federal law, ERISA, governs ERISA
claim denials and delays and pre-empts any and all state laws.
Aetna Health Inc. v. Davila
06/21/04
Opinion of the Court
"Held: Respondents’ state causes of
action fall within ERISA§502(a)(1)(B), and are therefore completely
pre-empted by ERISA §502 and removable to federal court. Pp. 4–20."
"We hold that respondents’ causes of
action, brought to remedy only the denial of benefits under
ERISA-regulated benefit plans,
fall within the scope of, and are completely pre-empted by, ERISA
§502(a)(1)(B), and thus removable to federal district court. The
judgment of the Court of Appeals is reversed, and the cases are
remanded for further proceedings consistent with this opinion.7 It
is so ordered."
On
January, 26, 2009, a unanimous U.S. Supreme court ruled that
ERISA plan administrator must follow ERISA regulation and Plan
documents with no exceptions to decide how pre-payment review and
timely benefit determination decisions should be made by “the terms of
the plan”. ERISA Statutes, 29 U. S. C. §1132(a)(1)(B), a straight
for-ward rule that lets employers “ ‘establish a uniform
administrative scheme, [with] a set of standard procedures to guide
processing of claims and disbursement of benefits in all pre-payment
reviews practice. ERISA forecloses any justification for enquiries
into expressions of intent from SIU Investigators, SIU of TPA/ASO
Medical Policies, and PPO guidelines, in favor of the virtues of
adhering to an uncomplicated rule from ERISA as intended by Congress.
SUPREME COURT OF THE UNITED STATES
Syllabus
KENNEDY, EXECUTRIX OF THE ESTATE OF
KENNEDY,
DECEASED v. PLAN ADMINISTRATOR FOR DUPONT
SAVINGS AND INVESTMENT PLAN ET AL.
CERTIORARI TO THE UNITED STATES COURT OF APPEALS FOR
THE FIFTH CIRCUIT
No. 07–636. Argued October 7, 2008—Decided January 26, 2009
""2. Although Liv’s waiver was not
nullified by §1056’s express terms, the plan administrator did its
ERISA duty by paying the SIP benefits to Liv in conformity with the
plan documents. ERISA
provides no exception to the plan administrator’s duty to act in
accordance with plan documents. Thus, the Estate’s claim
stands or falls by “the terms of the plan,”
29 U.
S. C. §1132(a)(1)(B), a straight for-ward rule that lets employers “
‘establish a uniform administrative scheme, [with] a set of standard
procedures to guide processing of claims and disbursement of
benefits,’ ” Egelhoff v. Egelhoff, 532 U. S. 141, 148.
By giving a plan participant a clear set of instructions for making
his own instructions clear, ERISA forecloses any justification for
enquiries into expressions of intent, in favor of the virtues of
adhering to an uncomplicated rule.
Less certain rules could
force plan administrators to examine numerous external documents
purporting to be waivers and draw them into litigation like this
over those waivers’ meaning and enforceability......."
This 2009 U.S. Supreme
court unanimous answered our current questions if ERISA pre-empts and
invalidates all TPA/ASO, PPO, SIU programs and state laws!
This is the latest, highest and unanimous ruling from U.S. Supreme
court.
Patient Protection and Affordable Care
Act, PPACA §2719, went
into effect upon its enactment of the act, on March 23, 2010, after
President Barack Obama signed PPACA into law. PPACA §2719 requires
every group health plan to comply with the established ERISA appeal
process, 29 CFR, §2560.503-1:
“SEC. 2719. APPEALS PROCESS.
`(a) Internal Claims Appeals-
`(1) IN GENERAL- A group health plan
and a health insurance issuer offering group or individual health
insurance coverage shall implement an effective appeals process for
appeals of coverage determinations and claims, under which the plan
or issuer shall, at a minimum—
`(A) have in
effect an internal claims appeal process;
`(B) provide notice to enrollees, in a
culturally and linguistically appropriate manner, of available
internal and external appeals processes, and the availability of any
applicable office of health insurance consumer assistance or
ombudsman established under section 2793 to assist such enrollees
with the appeals processes; and
`(C)
allow
an enrollee to review their file, to present evidence
and testimony as part of the appeals process, and to receive
continued coverage pending the outcome of the appeals process.
`(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
`(B) a health insurance issuer offering
individual health coverage, and any other issuer not subject to
subparagraph (A), shall provide an internal claims and appeals
process that initially incorporates the claims and appeals
procedures set forth under applicable law (as in existence on the
date of enactment of this section), and shall update such process in
accordance with any standards established by the Secretary of Health
and Human Services for such issuers.” (Emphasis added)
< http://thomas.loc.gov/cgi-bin/query/z?c111:H.R.3590.eas:>
Apparently, starting from March 23, 2010,
§2719 (a)(1)(A)(C) of PPACA requires every group health plan
and health insurance issuer for individual coverage to “(A) have in
effect an internal claims appeal process” and “(C)
allow an enrollee to review their file”,
the entire claim case file or administrative file regardless if the
plan is a statutory ERISA plan.
Strategies for
Pre-Payment Review Delays and Denials – Deemed Denial ERISA Appeals
Although specific deemed
denial appeals are beyond the scope of this article, the actual appeal
letter and form for deemed denial are 33 page long, the general
strategies are very simple:
-
No-pay or no-EOB / denial
notice after 30-45 days is considered "deemed denial" as provided by
ERISA claim regulation;
-
State Prompt Pay Laws are
useless or not applicable for
any ERISA plans, both
self-insured and full-insured (through purchase of insurance) plans,
and as soon as the plan did anything within 30 days, such as
pre-payment review notice, prompt pay laws are moot issues;
-
"Deemed Denial" triggers
your ERISA Miranda's Rights, ERISA Full and Fair Review - Appeals
Rights, your ERISA Constitutional Rights, to fight back against any
fraud and abuse by payers / TPA's as ERISA compliance initiatives;
-
After 45 days, you should
exercise your ERISA Miranda's Rights, file ERISA appeals with the
Plan Administrator, to demand for disclosure and compliance from the
plan and TPA's. Before the denial, you bear the burden of proof for
your claims, after the denial, the plan bears the burden of proof as
to why the claims were denied or not decided in a timely compliance
fashion;
-
Once "deemed denied",
you are the boss, the reviewer, to review the plan's failure in
compliance with ERISA, you must change from defense to offense,
aggressively investigate and report
to
DOL/FBI any abuse and
fraud by TPA's and plan administrators for any ERISA violations.
New Free ERISA Webinars from
ERISAclaim.com will review all governing federal laws, ERISA and PPACA,
for pre-payment reviews, and claim delays and denials, or ERISA deemed
denials without timely decisions under ERISA §2560.503-1(f)(2)(iii)(B).
Dr. Zhou will explain most compliant and effective ERISA appeals to
bring payers into compliance, for a timely payment that a healthcare
provider shall be legally entitled to under ERISA and relevant plan
provisions.
New ERISA Appeal Books Will provide The
Most Powerful Solution to the Pre-Payment Review Denials and Appeals,
as a turn-key appeal compliance practice for providers and payers
alike.
For any significant dollar size in
deemed denials, Dr. Jin Zhou is available for special on-site
consulting to assist you with quicker solutions.
For more information on our ERISA Appeal
CD Book and Systems, please visit
our website:
http://www.erisaclaim.com/products.htm
In the past 10 years, 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. Dr. Jin Zhou, president ERISAclaim.com has been regarded
as the Godfather of ERISA claims for healthcare providers by some in
Professional billing and coding industry.
For more information or to arrange an
interview, please contact Dr. Jin Zhou, president of ERISAclaim.com at
630-808-723 and ERISAclaim@aol.com or visit: <http://www.erisaclaim.com/products.htm>
###
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 Links:
ERISAclaim.com
Webinars On Healthcare Revenue Cycle Crisis Turnaround: Pre-Payment
Review Delays and Denials – Deemed Denial ERISA Appeals
04/19/2010, Hanover Park, IL
New Webinars Announced From
ERISAcaim.com To Resuscitate Revenue Cycle Crisis With Right Federal
Law Magic. Providers Are Seemingly Left With No Common Remedies In
Wake Of Financial Debilitating Overpayment Demand And Recoupment From
Payers, An Increasing Number Of Healthcare Providers Are Also Facing
Bankrupting Pre-Payment Review Delays For Up To Over A Year Of No-Pays
And Real Denials, In An Unprecedented U.S. Healthcare Avatar: No
Payment From Insurance Companies But Pay Back To Insurance Companies
By Providers. Once Informed Of Pre-Payment Reviews, All State Prompt
Pay Laws No Longer Apply.
Health Reform for
Out-Of-Network Providers: Receiving Insurance Checks Directly? –
Free Webinars on Why and How
04/05/2010, Hanover Park, IL
ERISAclaim.com Expanded Its Free
Webinars to Cover New Obama Health Reform and Reimbursement Laws for
Out-Of-Network Non-Participating Provider's Rights to Receive
Insurance Reimbursement Checks Directly with Valid Assignment and
Nondiscrimination Protections for Nonparticipation. New Obama Health
Reform Law Mandates Every Group and Individual Health Plan to Accept
Patient Assignment to Send Reimbursement Checks Directly to Providers
Regardless of Participation, by Incorporating Existing Federal Law,
ERISA, and in Consistent with Recent U.S. Supreme Court Orders.
Health Reform For
Doctors And Hospitals: Obama Made An Offer We Can’t Refuse!
-
ERISAclaim.com Celebrates its Successful
Webinars on New Healthcare Reimbursement Laws
04/05/2010, Hanover Park, IL
ERISAclaim.com Is Celebrating Its
Successful Webinars On New Healthcare Reimbursement Laws, Offered
Since The House Passed Its Version Of Sweeping Reform Bill In Last
November, And Subsequent Senate Bill With Identical Provisions For
Appeals Laws. After President Obama Signed Into Law The Final Bill On
March 23, 2010, Healthcare Providers Have Attended Its Daily Webinars
With Overwhelming Reactions: Obama Made An Offer We Can’t Refuse, “To
Receive Continued Coverage Pending The Outcome Of The Appeals
Process”.
New Free Webinars
Announced to Discuss the Latest Federal Court Overpayment Lawsuit
Ruling and New Obama Health Laws for the Skyrocketing $6 Trillion
Overpayment Recoupment Market
03-29-2010, Hanover Park, IL
New Free Webinars Announced From
ERISAclaim.com To Discuss The Latest And The First Federal Court
Ruling On March 18, 2010 That A PPO Participating Provider’s Lawsuit
Against Anthem BCBS, For The Alleged Wrongful Overpayment Recoupment
and Even Withholding From Different Patients, Is Completely Governed
By Federal Law, ERISA, Rather Than PPO Contracts And State Laws. The
Court Decision Was Mainly Relied Upon U.S. Supreme Court Rulings, the
Federal Court Ruling Is Timely Consistent With New Obama Health Reform
Laws That Mandate ERISA Appeals For All Group Health Plans And Health
Providers. The Federal Court Timely Ruling and New Health Reform Law
Mandates Are Vital and Crucial Guidance for a Potentially $6 Trillion
Overpayment Market for Every One In Healthcare Delivery System.
New Free Obama
Health Law Webinars Announced For Healthcare Providers and Health
Plans on New Reimbursement Laws for Claims Processing and Appeals
03-23-2010, Hanover Park, IL
The Final Health Reform Bill Has Been
Signed By President Obama Into The Law Of The Land For More Than 95%
Americans, As The Most Significant Changes Since Medicare Was Created
45 Years Ago. What Does Obama Healthcare Law Mean To Healthcare
Providers And Health Plans? New Free Webinars From ERISAclaim.com Was
Announced To Discuss New Federal Reimbursement Law Mandates For All
Group Health Plans And Health Care Providers: ERISA Internal And
External Appeals, Extended Disclosure And Appeal Rights, New Federal
UCR Fee Centers And New Federal Simplified, Uniform Standards For
Claim Processing And Appeals.
ERISAclaim.com: 50% Savings - Healthcare Crisis
Turnaround for Employers, Insurers & TPA's
ERISAclaim.com - A $1.0 Trillion Nuclear Solution
to U.S. Health-care Crisis & $44 Trillion Budget Deficits
American Benefits Council:
News Room - Supreme Court Ruling on Health Care Claims Raises Important
Policy Issues: American Benefits Council. June 21, 2004
"Sadly
and predictably trial attorneys and their allies are already calling on
Congress to unravel today’s decision by the Supreme Court, but they should
first ask why the two physicians in these cases did not act swiftly to help
make sure their patients got the care they were seeking.
In neither
case did the patient or their physician seek a further review of the health
plan’s initial coverage decision, despite being specifically informed of
their right to such a review under federal law."
Klein said."
"These
review procedures are available under ERISA
to help patients get the care they deserve, quickly and without having to
resort to costly and lengthy legal procedures. Clearly, a speedy and factual
review aided by the expertise of the physicians
involved with
these two cases could have avoided the need for the courts to be involved at
all,"
Klein said."
# # #
The American Benefits Council is the national
trade association for companies concerned about federal legislation
and regulations affecting all aspects of the employee benefits system.
The Council's members
represent the entire spectrum of the private employee benefits
community and either sponsor directly or administer retirement and
health plans covering more than 100 million Americans."
http://www.americanbenefitscouncil.org/issues/health/mischealth.htm
Lexology - Notes on the National Summit on Health Care Fraud
Reed Smith LLP,
Last
week, in my capacity as president of the
American Health
Lawyers Association, I attended the first
National Summit on
Health Care
Fraud,
a joint undertaking by the
U.S. Department of
Health and Human Services and the
U.S. Department of Justice. The conference brought together
private sector leaders, law enforcement personnel, and
health
care experts as part of the Obama Administration’s coordinated effort
to fight health
care fraud.
This was the first national gathering on
health
care fraud
between law enforcement and the private and public sectors."
STOP Medicare Fraud
- U.S. Department of Health & Human Services and U.S. Department of
Justice (http://www.stopmedicarefraud.gov)
"National
Summit on Health Care Fraud
U.S.
Department of Health and Human Services Secretary Kathleen Sebelius
and Attorney General Eric Holder convened a “National Summit on
Health Care Fraud” on Thursday January 28, to bring together leaders
from the public and private sectors to identify and discuss
innovative ways to eliminate fraud, waste and abuse in the U.S.
health care system. The National Summit is the latest initiative of
the Health Care Fraud Prevention & Enforcement Action Team (HEAT)."
Related Press Release links:
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
Free Overpayment Webinar Announced For
Self-insured Health Plans To Get Immediate Relief from New $1 Trillion
Overpayment Recoupment Embezzlement Market 11-23-2009,
Hanover Park, IL
New Healthcare
Overpayment Recoupment Embezzlement Recovery Service Announced In Wake
Of Launch of New Federal Task Force To Combat Healthcare Fraud Crisis 11-19-2009, Hanover Park, IL
The New Healthcare
Reform Bill Passed by The Congress Prompted The New Claim Specialist
Certification Class from ERISAclaim.com 11-9-2009, Hanover Park, IL
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
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