Extension of Nonenforcement Period for Certain Internal Claims

Technical Release No. 2011-01 provides an extension of the non-enforcement period relating to certain interim procedures for internal claims and appeals under the Affordable Care Act.

Document Excerpt

The Departments of Labor, Health and Human Services (HHS), and the Treasury (the Departments) have been issuing regulations in several phases to implement the revised Public Health Service Act (PHS Act) sections 2701 through 2719A and related provisions of the Patient Protection and Affordable Care Act (Affordable Care Act). Section 2719 of the PHS Act sets forth standards for plans and issuers that are not grandfathered health plans regarding internal claims and appeals and external review. The Departments published interim final regulations implementing PHS Act section 2719 on July 23, 2010, at 75 FR 43330 (the 2010 interim final regulations).

On September 20, 2010, the Department of Labor issued Technical Release 2010-02 (T.R. 2010-02), which set forth an enforcement grace period for compliance with certain new provisions with respect to internal claims and appeals until July 1, 2011.(1) Based on a review of the comments received on the 2010 interim final regulations and other feedback from interested stakeholders, this document, Technical Release 2011-01, modifies and extends the enforcement grace period set forth in T.R. 2010-02, as set forth below.

The Departments intend to issue an amendment to the 2010 interim final regulations in the near future that takes into account comments and other feedback received from stakeholders on the 2010 interim final regulations, and makes modifications to certain provisions of the 2010 interim final regulations. To avoid enforcing standards that the Departments intend to modify in the near future, the relief contained in this Technical Release 2011-01 is intended to act as a bridge until an amendment to the 2010 interim final regulations is issued.(2)

Link http://www.dol.gov/ebsa/newsroo


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