Interim final rules for the appeals and external claims process required by the Patient Protection and Affordable Care Act for nongrandfathered self-insured group health plans

? -Effective for policy years beginning on or after Sept. 23.

? -Self-insured plans must contract with at least three accredited independent review organizations.

? -Claimants have four months to file a request for an external review.

? -Preliminary review must be completed within five business days.

? -External reviews must be completed within 45 business days.

? -Claimant can request an expedited review for a medical condition that could seriously jeopardize life, health or the ability to regain maximum function.

? -IRO must complete an expedited review within 72 hours.

Source: U.S. Department of Labor, Health and Human Services, Internal Revenue Service