Hoyer Applauds Announcement of New Health Reform Rules

New Rules Grant Patients the Right to Appeal Health Plan Decisions   

WASHINGTON, DC – Congressman Steny H. Hoyer (MD-5) released the following statement after the Obama Administration announced new regulations that give consumers in new health plans the right to appeal decisions, including claims denials and rescissions, made by their health plans.  This is a provision made available by the Affordable Care Act and part of the Act's critically important Patient's Bill of Rights.

"The intent of the Affordable Care Act was to put patients in control of their healthcare," stated Rep. Hoyer.  "The new rules announced by the Obama Administration will do just that, empowering Americans with new rights and resources that will help ensure that they have a strong voice if they are denied the care they need when they need it. I have consistently fought for measures like this, and by simplifying the appeals process for consumers, we are taking one more step to ensure that families have control of their healthcare, not insurance companies."

The new appeals regulations were issued by the Departments of Health and Human Services (HHS), Labor, and the Treasury and allow consumers in new health plans in every state 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.

For more information about the new appeals regulation or Consumer Assistance Grants program, go to http://www.healthcare.gov/news/factsheets

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