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) January 4, 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.
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