Implementing External Review Processes

Non-grandfathered group health plans must soon implement external review processes for benefit claim determinations. Our recent Benefits Alert discusses the new agency guidance on how external reviews should work—and how plans can get a little relief. Today's post was contributed by Jessica Faith. …

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Six Months And Counting

You have probably heard a lot about the health care reform provisions that “went into effect” last week. To clarify, these provisions are effective for plan years beginning on or after September 23, 2010; for calendar-year plans, the rules will not apply until January 1, 2011. Grandfathered plans are exempt …

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Alternative Suppliers Notification Requirement: Do Hospitals Have to Comply?

As we discussed in a previous post, Section 6003 of the Patient Protection and Affordable Care Act (PPACA) requires physician groups relying on the “in-office ancillary services” exception to the Stark Law for referrals of MRIs, PET scans and CTs to let patients know of other options to obtain these services. …

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CMS Issues Voluntary Self-Referral Disclosure Protocol

Today CMS issued its voluntary self-referral disclosure protocol (SRDP) as required under Section 6409 of the Patient Protection and Affordable Care Act (PPACA). Section 6402 of PPACA requires certain providers, suppliers and other entities to report and return overpayments by the later of (i) 60 days after the …

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Corporate Wellness Opportunities under Health Care Reform

Health care reform has several provisions that promote corporate wellness opportunities: Small business wellness grants. Health care reform provides $200 million for HHS to award grants to employers with under 100 employees who establish new comprehensive workplace wellness programs between 2011 and 2015. HHS …

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Faegre & Benson Named Top-Tier Health Care Practice by U.S. News

In its inaugural law firm ranking, U.S. News and World Report and Best Lawyers ranked Faegre & Benson as a Tier 1 firm for health care law in Colorado and Minneapolis. The report does not rank health care firms on a national basis. The firm’s employment and employee benefits practices were also recognized …

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