The Obama administration announced new rules last week that give consumers greater power to appeal decisions made by their health plans or insurance companies.
According to the U.S. Department of Health and Human Services, consumers in new health plans in every state will have the right to appeal decisions, including claims denials and rescissions, made by their health plans. This includes the right to appeal decisions made by a health plan through the plan's internal process and, for the first time, the right to appeal decisions made by a health plan to an outside, independent decision-maker, no matter what state a patient lives in or what type of health coverage they have.
In addition, grant applications from the $30 million Consumer Assistance Program are now available to help states and territories establish consumer assistance offices or strengthen existing ones. The new funds will be used to provide consumers with the information they need to pick from a range of coverage options that best meets their needs, appeal decisions by plans to deny coverage of needed services, and to select an available primary care provider of their choosing.
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