On the 36th birthday of ERISA (09/02/1974), ERISAclaim.com announced a new historical “Obama-Appeal” Seminar in Chicago on Sep. 23, 2010 to lead and mark the new era of U.S. healthcare history, for all health care claim denials and appeals for all healthcare providers. On March 23, 2010, Pres. Obama signed Health Reform into law, Patient Protection and Affordable Care Act, PPACA. On July 23, 2010, IRS, DOL and HHS released new federal appeals regulations. On August 24, 2010, the same federal agencies released new Federal EOB (Explanation of Benefits) Regulations and Federal External Review Regulations, Notice for self-insured plans. On Sep. 23, 2010, new federal appeals regulations under PPACA will go into effect, for all group health plans and individual policies and all health care providers. The new Obama-Appeal laws adopted and will re-enforce the existing federal ERISA laws for both grandfathered and non-grandfathered health plans.
36 years ago today, on Sep. 02, 1974, President Gerald R. Ford signed ERISA into law:
http://www.pbgc.gov/about/signing.html
On Obama Appeals Effective Date, for a copy of News Release, new Obama Appeals Regulations & PPACA:
http://www.dol.gov/ebsa/newsroom/2010/ebsa072210.html
http://www.dol.gov/federalregister/HtmlDisplay.aspx?DocId=24056&AgencyId=8&DocumentType=2
http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111_cong_public_laws&docid=f:publ148.pdf
“The entire success of Obama Health Care Reform, or Obama Patients Bill Of Rights, is mainly and finally depending upon the last step of health care design and delivery – the successful reimbursement of health care services,” said Dr. Jin Zhou, Pres. of ERISAclaim.com, the only company in the nation offering comprehensive education on new federal appeals laws for healthcare providers and health plans.
“If not a single healthcare provider or billing coding professional is educated on the new federal appeals laws and regulations, after we went through the political Katrina and constitutional showdown in Congress last year, all of our legislative and regulatory solutions will be completely useless for our healthcare and financial crisis,” said Dr. Zhou, “even though the new federal regulations have provided consumers and providers with most powerful and comprehensive protections for almost every problems encountered today in healthcare market”.
The purpose to hold this historical Obama-Appeal Seminar on Sep. 23, 2010 is to ensure that ObamaCare will not turn into Obama-Insanity: “doing the same thing over and over again and expecting different results” as defined by Einstein, explained by Dr. Zhou, by educating all health care providers, coding, billing professionals and health plans, TPA’s as well as IRO’s on the new Federal Clams and Appeals Regulations.
Dr. Zhou further elaborated that ERISA Insanity has been a reality for 36 years since ERISA has been the governing law for more than 50% of $2.6 trillion in U.S. healthcare expenditure each year while no ERISA claim regulation education and enforcement ever existed, except for ERISA education from ERISAclaim.com in the past 10 years. Without PPACA claims and appeals regulation education, health reform will be impossible, as envisioned by Pres. Obama on January 9, 2010 in his weekly address to the nation:
“And there will be a new, independent appeals process for anyone who feels they were unfairly denied a claim by their insurance company……In short, once I sign health insurance reform into law, doctors and patients will have more control over their health care decisions, and insurance company bureaucrats will have less. All told, these changes represent the most sweeping reforms and toughest restrictions on insurance companies that this country has ever known.”
http://www.whitehouse.gov/the-press-office/weekly-address-president-obama-outlines-benefits-health-reform-take-effect-year
Effective on Sep. 23, 2010, new federal external review laws as Pres. Obama praised will provide a new speedy resolution without having to go to a court each time, and any violation of the new federal external appeal laws by an insurer, HMO or TPA will be fined in $100 excise tax penalty per day per patient, added by Dr. Zhou.
http://www.dol.gov/ebsa/pdf/ACATechnicalRelease2010-01.pdf
According to Dr. Zhou, new federal claims and appeals regulations will affect every health care claims outside Medicare, including insurance benefits verification, claim submissions, eligibility for providers, pre-certification, policy coverage and limitation, medical necessity, UCR, bundling and down-coding, overpayment demand and recoupment, urgent care, pre-existing conditions, and any claim payment less than 100% as submitted. PPACA, sec. 2706 of PHS Act, specifically prohibits any discrimination against any health care providers regardless of any network participation.
The Obama-Appeal Seminar will be held for two days from Sep. 22 to Sep. 23, 2010 in Chicago suburbs, covering every basic topics of PPACA, new federal internal and external appeals regulations. More advanced certification programs on PPACA-ERISA claim specialists will be followed right after Sep. 23, 2010.
For news on future basic and advanced programs: http://www.erisaclaim.com/Press_Releases.htm
ERISAclaim.com, said Dr. Zhou, will be interested in co-sponsoring, strategic alliance and networking for more seminars, certification or accreditation programs on PPACA-ERISA Claims & Appeals Regulations with other concerned organizations from billing and coding professionals, health care providers, group health plans, TPA’s & IRO’s. Please contact Dr. Zhou of ERISAclaim.com for further information.
ERISAclaim.com has been offering these educational Webinars, Seminars and Certifications Classes on ERISA for 10 years and on new Health Reform Laws since the Health Bill was signed into law by President Obama on 03/23/2010. These ongoing Webinars, Seminars and Certification Classes were scheduled on bi-weekly, monthly and customer request basis to teach basic, practical and expert level of appeals practice strictly in accordance with new and existing Federal Appeals Regulations for all types of claim denials and delays.
Happy Birthday to You, ERISA! (09/02/1974 – 09/02/2010)
For more information, please visit http://www.erisaclaim.com/seminars.htm, or contact Dr. Jin Zhou, president of ERISAclaim.com, at 630-808-7237.
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Source – http://www.prweb.com/releases/2010/09/prweb4452894.htm
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