Consumers Slam New HHS Rules On Appeals

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Consumer advocates aren't happy with revised regulations on the process for filing appeals when insurers deny claims.

The advocacy group Consumer Watchdog accused the Health and Human Services Department of bowing to the insurance industry by relaxing some of the standards for review.

HHS had initially proposed giving consumers 120 days after a denial to request an external review. The department shortened that window to 60 days in a final rule released Wednesday. The new draft also gave insurers more time to review urgent claims — 72 hours, compared with 24 hours in the earlier version.

The regulations implement a provision of the healthcare reform law. The new review process is the only option for people whose employers self-insure, Consumer Watchdog said. The group argued that HHS's revisions weaken protections for those employees.

"Health reform was intended to strengthen the public’s ability to make insurers provide the coverage patients are promised," Carmen Balber, the group's Washington director, said in a statement. "The administration should reverse the changes in this regulation that undermine that promise."

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