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Health Reform For Doctors And Hospitals: Obama Made An Offer We Can't Refuse! - ERISAclaim.com Celebrates its Successful Webinars on Reimbursement Laws
Date:4/5/2010

I obtained from DOL. The sum of this information raised more questions than it answered. After this webinar and having my questions answered, I felt for the first time, confident that I understood ERISA and its day-to-day application of the ERISA law to claims processes."

According to Dr. Jin Zhou, president of ERISAclaim.com, a national ERISA expert, and reimbursement compliance consultant, since March 23, 2010, President Obama signed into law the health reform bill, for more than 95% of Americans, with most significant overhaul to U.S. healthcare delivery system and reimbursement laws, health care providers and health plans alike are faced with lack of information, misinformation and frustrations on new Obama health reimbursement laws.

What does this new Obama health law mean to healthcare providers and health plans as well as TPAs?

Dr. Jin Zhou explained that contrary to popular misinformation, the Obama health law, Patient Protection and Affordable Care Act, PPACA, has established significant consumer protections and plan claim processing and appeal simplification to reduce administrative costs and enhance provider reimbursement rights and patient protections. New Obama health law incorporates or adopts existing ERISA claim regulation in its entirety as internal ERISA appeal mandates, and Uniform External Review Model Act promulgated by the National Association of Insurance Commissioners as external ERISA appeal mandates as final and binding authority to all parties, in absence of judicial appeals. New Obama health law upgraded and extended existing ERISA appeal regulation with new EOB requirements, greater patient and provider rights to access to entire claim file and to present evidence and testimony as part of the appeals process.

One of the most striking and powerful protections from PPACA for consumers is "to receive continued coverage pending the outcome of the appeals process", in addition to new ERISA
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