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	<title>Passion for Subro &#187; Claims Review</title>
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	<link>http://www.passionforsubro.com</link>
	<description>The personal subrogation blog of Attorney Adam V. Russo.</description>
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		<title>Plan’s Choice to Shun Claims Procedures Causes ERISA Charges</title>
		<link>http://www.passionforsubro.com/claims-review/plan%e2%80%99s-choice-to-shun-claims-procedures-causes-erisa-charges/</link>
		<comments>http://www.passionforsubro.com/claims-review/plan%e2%80%99s-choice-to-shun-claims-procedures-causes-erisa-charges/#comments</comments>
		<pubDate>Mon, 21 Nov 2011 00:58:12 +0000</pubDate>
		<dc:creator>cmonfils</dc:creator>
				<category><![CDATA[Claims Review]]></category>
		<category><![CDATA[ERISA]]></category>
		<category><![CDATA[PPACA]]></category>
		<category><![CDATA[Tennessee]]></category>

		<guid isPermaLink="false">http://www.passionforsubro.com/?p=7860</guid>
		<description><![CDATA[Employer’s Guide to Self-Insuring Health Benefits Thompson Publishing                  November 2011      Vol. 19, No. 2 A plan’s decision to circumvent its own written appeals procedures led to ERISA claims. In a dispute involving an experimental service denial, plan administrator Viacom and claims administrator United Healthcare told a plan participant to skip the plan’s normal appeals route [...]]]></description>
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		<title>PPACA, HIPAA and Federal Health Benefit Mandates: Practical</title>
		<link>http://www.passionforsubro.com/claims-review/ppaca-hipaa-and-federal-health-benefit-mandates-practical-2/</link>
		<comments>http://www.passionforsubro.com/claims-review/ppaca-hipaa-and-federal-health-benefit-mandates-practical-2/#comments</comments>
		<pubDate>Fri, 16 Sep 2011 19:07:11 +0000</pubDate>
		<dc:creator>cmonfils</dc:creator>
				<category><![CDATA[Claims Review]]></category>
		<category><![CDATA[DOL]]></category>
		<category><![CDATA[ERISA]]></category>
		<category><![CDATA[External Claim Review]]></category>
		<category><![CDATA[HIPAA]]></category>
		<category><![CDATA[PPACA]]></category>
		<category><![CDATA[Self-Funding]]></category>

		<guid isPermaLink="false">http://www.passionforsubro.com/?p=7282</guid>
		<description><![CDATA[The Self-Insurer                               August 2011 By Carolyn Smith, Esq. and John Hickman, Esq., Alston &#38; Bird, LLP New Claim Review Regulations Ease Compliance Burdens For Group Health Plans                 On June 24, 2011, the U.S. Department of Treasury, Labor (DOL) and Health and Human Services (HHS) (collectively, the “Agencies”) jointly issued new interim final regulations (“Final [...]]]></description>
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		<title>PPACA, HIPAA and Federal Health Benefit Mandates: Practical</title>
		<link>http://www.passionforsubro.com/claims-review/ppaca-hipaa-and-federal-health-benefit-mandates-practical/</link>
		<comments>http://www.passionforsubro.com/claims-review/ppaca-hipaa-and-federal-health-benefit-mandates-practical/#comments</comments>
		<pubDate>Tue, 23 Aug 2011 00:17:16 +0000</pubDate>
		<dc:creator>cmonfils</dc:creator>
				<category><![CDATA[Claims Review]]></category>
		<category><![CDATA[DOL]]></category>
		<category><![CDATA[External Claim Review]]></category>
		<category><![CDATA[HHS]]></category>
		<category><![CDATA[HIPAA]]></category>
		<category><![CDATA[PPACA]]></category>

		<guid isPermaLink="false">http://www.passionforsubro.com/?p=7103</guid>
		<description><![CDATA[The Self-Insurer                August 2011  By Carolyn Smith, Esq. and John Hickman, Esq., Alston &#38; Bird, LLP New Claim Review Regulations Ease Compliance Burdens For Group Health Plans           On June 24, 2011, the U.S. Department of Treasury, Labor (DOL) and Health and Human Services (HHS) (collectively, the “Agencies”) jointly issued new interim final regulations (“Final [...]]]></description>
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		<slash:comments>0</slash:comments>
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		<title>Claims Appeal and Review Obligations Lessened to Relief of Plans, Insurers</title>
		<link>http://www.passionforsubro.com/claims-review/claims-appeal-and-review-obligations-lessened-to-relief-of-plans-insurers/</link>
		<comments>http://www.passionforsubro.com/claims-review/claims-appeal-and-review-obligations-lessened-to-relief-of-plans-insurers/#comments</comments>
		<pubDate>Thu, 04 Aug 2011 14:35:48 +0000</pubDate>
		<dc:creator>cmonfils</dc:creator>
				<category><![CDATA[Claims Review]]></category>
		<category><![CDATA[DOL]]></category>
		<category><![CDATA[External Claim Review]]></category>
		<category><![CDATA[Health Care Legislation]]></category>
		<category><![CDATA[HHS]]></category>

		<guid isPermaLink="false">http://www.passionforsubro.com/?p=6933</guid>
		<description><![CDATA[Claims Appeal and Review Obligations Lessened to Relief of Plans, Insurers July, 2011 Thompson Publishing Group Plans and insurers will have an easier time complying with health reform’s internal appeals and external review rules, under rules the U.S. Departments of Labor, Treasury and Health and Human Services issued June 24. The changes, such as dropping [...]]]></description>
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		<slash:comments>0</slash:comments>
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		<title>ERIC Cautions Regulators to Avoid Burdensome Claims and Appeals Requirements</title>
		<link>http://www.passionforsubro.com/claims-review/eric-cautions-regulators-to-avoid-burdensome-claims-and-appeals-requirements/</link>
		<comments>http://www.passionforsubro.com/claims-review/eric-cautions-regulators-to-avoid-burdensome-claims-and-appeals-requirements/#comments</comments>
		<pubDate>Thu, 28 Jul 2011 19:25:04 +0000</pubDate>
		<dc:creator>cmonfils</dc:creator>
				<category><![CDATA[Claims Review]]></category>
		<category><![CDATA[PPACA]]></category>

		<guid isPermaLink="false">http://www.passionforsubro.com/?p=6900</guid>
		<description><![CDATA[www.eric.org     Jul 25, 2011  ERIC News Release For Immediate Release: July 25, 2011 Washington, D.C. &#8212; The ERISA Industry Committee (ERIC) today submitted comments on the amendment to the interim final regulations implementing the internal claims and appeals and external review processes under the Patient Protection and Affordable Care Act (ACA). The Departments of Labor, Health [...]]]></description>
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		<slash:comments>0</slash:comments>
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		<title>DOL, HHS, and IRS Issue Amendments to Rules Relating to Internal Claims and Appeals and External Review Processes under the Affordable Care Act</title>
		<link>http://www.passionforsubro.com/claims-review/dol-hhs-and-irs-issue-amendments-to-rules-relating-to-internal-claims-and-appeals-and-external-review-processes-under-the-affordable-care-act/</link>
		<comments>http://www.passionforsubro.com/claims-review/dol-hhs-and-irs-issue-amendments-to-rules-relating-to-internal-claims-and-appeals-and-external-review-processes-under-the-affordable-care-act/#comments</comments>
		<pubDate>Thu, 28 Jul 2011 19:20:36 +0000</pubDate>
		<dc:creator>cmonfils</dc:creator>
				<category><![CDATA[Claims Review]]></category>
		<category><![CDATA[DOL]]></category>
		<category><![CDATA[HHS]]></category>
		<category><![CDATA[PPACA]]></category>

		<guid isPermaLink="false">http://www.passionforsubro.com/?p=6894</guid>
		<description><![CDATA[www.mintz.com   By Alden J. Bianchi and Patricia A. Moran    July 19‚ 2011  The “insurance market reform” provisions of the Patient Protection and Affordable Care Act as amended by the Health Care and Education Reconciliation Act of 2010 (together, the Act) generally require health insurance issuers in the individual and group markets, and employer-sponsored group health [...]]]></description>
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		<slash:comments>0</slash:comments>
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		<title>Health Care Reform: Summary of Amended Regulations on Claims and Appeal Procedures for Group Health Plans</title>
		<link>http://www.passionforsubro.com/claims-procedures/health-care-reform-summary-of-amended-regulations-on-claims-and-appeal-procedures-for-group-health-plans/</link>
		<comments>http://www.passionforsubro.com/claims-procedures/health-care-reform-summary-of-amended-regulations-on-claims-and-appeal-procedures-for-group-health-plans/#comments</comments>
		<pubDate>Thu, 21 Jul 2011 19:26:34 +0000</pubDate>
		<dc:creator>cmonfils</dc:creator>
				<category><![CDATA[Claims Procedures]]></category>
		<category><![CDATA[Claims Review]]></category>
		<category><![CDATA[Health Care Legislation]]></category>

		<guid isPermaLink="false">http://www.passionforsubro.com/?p=6861</guid>
		<description><![CDATA[www.dwt.com     By Dipa N. Sudra and Jeff Belfiglio     07.14.11 Health care reform requires nongrandfathered group health plans, both insured and self-insured, to change their internal claims procedures and external review procedures. Even as plans work to implement these rules, the Internal Revenue Service, the Department of Labor, and the Department of Health and Human Services [...]]]></description>
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		<slash:comments>0</slash:comments>
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		<title>Captives Help Create Innovative Programs</title>
		<link>http://www.passionforsubro.com/claims-procedures/captives-help-create-innovative-programs/</link>
		<comments>http://www.passionforsubro.com/claims-procedures/captives-help-create-innovative-programs/#comments</comments>
		<pubDate>Thu, 05 May 2011 19:23:21 +0000</pubDate>
		<dc:creator>cmonfils</dc:creator>
				<category><![CDATA[Accountable Care Organizations]]></category>
		<category><![CDATA[Claims Procedures]]></category>
		<category><![CDATA[Claims Review]]></category>

		<guid isPermaLink="false">http://www.passionforsubro.com/?p=6372</guid>
		<description><![CDATA[www.businessinsurnce.com  INNOVATION IS a hallmark of successful leaders in all areas of business, and innovation clearly is a key attribute of the risk managers we honor with our 2011 Risk Manager of the Year award and Risk Management Honor Roll.One striking feature of all the honorees&#8217; risk management programs is the innovative use of captives. [...]]]></description>
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		<slash:comments>0</slash:comments>
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		<title>When Do PPACA Claims &amp; Appeals Rules Apply?</title>
		<link>http://www.passionforsubro.com/claims-procedures/when-do-ppaca-claims-appeals-rules-apply/</link>
		<comments>http://www.passionforsubro.com/claims-procedures/when-do-ppaca-claims-appeals-rules-apply/#comments</comments>
		<pubDate>Mon, 25 Apr 2011 14:08:41 +0000</pubDate>
		<dc:creator>cmonfils</dc:creator>
				<category><![CDATA[Claims Procedures]]></category>
		<category><![CDATA[Claims Review]]></category>
		<category><![CDATA[PPACA]]></category>

		<guid isPermaLink="false">http://www.passionforsubro.com/?p=6248</guid>
		<description><![CDATA[www.plansponsor.com April 19, 2011 (PLANSPONSOR.com) &#8211; The effective dates for the new claims and appeals requirements under PPACA have changed more than once (even since we&#8217;ve written about this issue before).   Not surprisingly, we have been receiving a number of questions asking us to clarify these various dates.  The Department of Labor issued a grace [...]]]></description>
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		<slash:comments>0</slash:comments>
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		<title>Discovery Permitted To Determine Scope Of Administrative Record</title>
		<link>http://www.passionforsubro.com/claims-procedures/discovery-permitted-to-determine-scope-of-administrative-record/</link>
		<comments>http://www.passionforsubro.com/claims-procedures/discovery-permitted-to-determine-scope-of-administrative-record/#comments</comments>
		<pubDate>Wed, 02 Feb 2011 13:31:02 +0000</pubDate>
		<dc:creator>cmonfils</dc:creator>
				<category><![CDATA[Claims Procedures]]></category>
		<category><![CDATA[Claims Review]]></category>
		<category><![CDATA[ERISA]]></category>
		<category><![CDATA[Litigation]]></category>

		<guid isPermaLink="false">http://www.passionforsubro.com/?p=4814</guid>
		<description><![CDATA[www.healthplanlaw.com January 18, 2011 In the present case, the plaintiff asserts its procedural challenge on the grounds that, given the different versions of the administrative record produced during discovery, many of which lacked important medical records initially provided by the plaintiff, it is impossible to determine what comprises the full administrative record on which the [...]]]></description>
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