Labor, Treasury, HHS Offer Safe Harbor for PPACA Claims, Appeals

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Labor, Treasury, and HHS issue guidance (Technical Release 2010-02) providing an enforcement grace period until July 1, 2011, to give group health care plans and insurance issuers more time to comply with rules on new internal claims and appeals procedures under the new health care reform law. The departments issued interim final rules (T.D. 9494) in July to standardize and strengthen the process by which consumers can appeal medical coverage or claims denials by their health insurance. The rules are effective for plan years beginning on or after tomorrow, but because plan years are often based on the calendar year, the changes most likely will not become widespread until Jan. 1, and the safe harbor will give plans more time to implement procedures and make changes to computer systems to comply fully with the rules, the departments say.

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