2011: Health Care Reimbursement Under New Health Reform Laws – With Criminal, Prompt Pay Enforcement, and More PPACA & ERISA Claims Specialists

Hanover Park, IL (Vocus/PRWEB) January 03, 2011

Beginning on Jan. 01, 2011, new federal internal and external claims regulations under health reform laws, PPACA, and new criminal and prompt pay enforcement on 36 year old federal ERISA claims regulations are effective for all health plans and individual policies with prompt pay and criminal enforcement protections. Patient Protection and Affordable Care Act, PPACA, is the most significant healthcare law change in 45 years since Medicare was created. On November 16, 2010, Department of Labor'sEmployee Benefits Security Administration (EBSA) initiated the Contributory Plans Criminal Project (CPCP) to combat criminal abuse of contributory health benefit plans. In 2010, ERISAclaim.com offered more than dozens of PPACA & ERISA Webinars nationwide and entered numerous contracts of PPACA & ERISA Claims Specialists Certification Training Programs. In 2011, ERISAclaim.com will lead U.S. healthcare reimbursement history under PPACA and ERISA, The New Patient’s Bill of Rights through compliance and anti-fraud education, the PPACA & ERISA Claims Specialists Certification Training Programs.

New federal claims and appeals regulation went into effect on September 23, 2010, with an enforcement grace period until July 2, 2011, for all non-grandfathered group health plans and individual policies in claims timely reimbursement and appeals. Most group health plans have plan new calendar year starting on Jan. 01, 2011, thus must comply with new federal internal and external prompt pay laws, the internal and external claims and appeals regulations. PPACA claims and appeals regulations adopts existing federal ERISA claims regulations of 36 years in its entirety as PPACA’s minimum and key requirements, with 6 new patient rights requirements and provides new federal external appeals based on existing NAIC Uniform External Review Model Act. Thus, without education and compliance with ERISA, PPACA will be meaningless for patients’ reimbursement rights.

Since PPACA was signed into law on March 23, 2010, ERISAclaim.com has been the only one in the nation to offer PPACA & ERISA compliance education for claims and appeals by healthcare providers. In 2011, ERISAclaim.com will lead the U.S. healthcare history to meet PPACA’s full enforcement deadline on July 02, 2011 with free PPACA & ERISA Webinars and PPACA & ERISA Claims Specialist Certification Programs.

“Although PPACA’s individual mandate for insurance is under constitutional challenge in the court, PPACA’s claims and appeals provisions are never in controversy and ERISA has been the governing law for 36 years for all employer sponsored health plans. If you want to get paid now, you must comply with the laws on the book today, not in the future,” said Dr. Jin Zhou, President of ERISAclaim.com, a national expert on ERISA and PPACA.
All health plans and individual polices must now substantially comply with existing ERISA regulation of 36 years with respect to timely benefits determination, “immediately paying benefits” upon benefits determinations with approved payments under 29 CFR §2560.503-1(f), explained Dr. Zhou.

Dr. Zhou reiterated the latest federal government criminal enforcement to punish those who defraud health plans and to deter others who might contemplate such crimes:

U.S. Labor Department Announces Nationwide Enforcement Actions To Protect Millions Of Dollars In Worker Retirement And Health Benefits: http://www.dol.gov/ebsa/newsroom/2010/10-1614-NAT.html

DOL EBSA: Fact Sheet: Contributory Plans Criminal Project: http://www.dol.gov/ebsa/pdf/fscpcp.pdf

ERISAclaim.com’s PPACA & ERISA Claim Specialists Certification Programs are established to provide expert guidance in understanding, implementation and compliance with PPACA:

Complete Affordable Care Act Regulations and Guidance can be found on DOL website:
http://www.dol.gov/ebsa/healthreform/

HHS, DOL & IRS: “Fact Sheet: The Affordable Care Act’s New Patient’s Bill of Rights”
http://www.healthreform.gov/newsroom/new_patients_bill_of_rights.html

HHS, DOL & IRS News Release: “Administration Announces New Affordable Care Act Measures to Protect Consumers and Put Patients Back in Charge of Their Care”
http://www.hhs.gov/news/press/2010pres/07/20100722a.html

HHS, DOL & IRS: “Fact Sheet: The Affordable Care Act: Protecting Consumers and Putting Patients Back in Charge of Their Care July 22, 2010

The Affordable Care Act will help support and protect consumers and end some of the worst insurance company abuses. For too long, consumers have been forced to fend for themselves in a health care system that did not provide them with the support and assistance they needed and deserved. Today, the Obama Administration is announcing new regulations that will allow consumers to appeal decisions made by their health plans and the availability of resources that will be used to help give consumers more control of their health care decisions.” http://www.healthcare.gov/news/factsheets/protectconsumers_factsheet072210.pdf

Located in a Chicago suburb in Illinois, ERISAclaim.com is the only ERISA & PPACA consulting, publishing and website resource for healthcare providers in the country. ERISAclaim.com offers free webinars, basic and advanced educational seminars and on-site claims specialist certification programs for doctors, hospitals and commercial companies, as well as litigation support. Dr. Jin Zhou is regarded as the industry “Godfather of ERISA claims” for healthcare providers.

For more information on how to become an ERISA-PPACA & ERISA Claims Specialist under new and existing federal appeals regulations: http://www.erisaclaim.com/certification.htm.

For free Webinars: http://www.erisaclaim.com/Free_ERISA_Webnars.htm

For any questions, please contact Dr. Jin Zhou, president of ERISAclaim.com, at 630-808-7237.

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Read the full story at http://www.prweb.com/releases/2011/1/prweb8041718.htm