Transcription of February 1, 2022
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February 1, 2022
1 DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services Center for Consumer Information & Insurance Oversight 200 Independence Avenue SW Washington, DC 20201 Date: From: Title: February 1, 2022 Center for Consumer Information & Insurance Oversight (CCIIO), Centers for Medicare & Medicaid Services (CMS) Guidance for States, Plans, and Issuers on State External Review Processes Regarding Requirements in the No Surprises Act Background: Under the Affordable Care Act (ACA), consumers have the right to appeal decisions made by health plans created after March 23, 2010. The law governs how insurance companies handle initial appeals and how consumers can request a reconsideration of a decision to deny payment.
or issuer under Internal Revenue Code section 9816 or 9817, Employee Retirement Income Security (ERISA) section 716 or 717, or PHS Act section 2799A-1 or 2799A-2, as added by the CAA. 1. Substantively similar regulations are 26 CFR 54.9815-2719T and 29 CFR 2590.715-2719, related to plans subject
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