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HHS/CMS RIN: 0938-AQ66 Publication ID: Spring 2011 
Title: ●Internal Claims, Appeals, and External Review Processes Under the Affordable Care Act (CMS-9993-IFC2) 
Abstract: The Affordable Care Act provides consumers with the right to appeal decisions made by their health carrier to an outside, independent decision maker, regardless on the State of residence or type of health insurance. Under interim final regulations issued earlier this year, non-grandfathered plans and issuers must comply with a State external review process or the Federal external review process. This rule would finalize the regulation and provide an opportunity to respond to public comments. 
Agency: Department of Health and Human Services(HHS)  Priority: Other Significant 
RIN Status: First time published in the Unified Agenda Agenda Stage of Rulemaking: Final Rule Stage 
Major: Undetermined  Unfunded Mandates: No 
CFR Citation: Not Yet Determined     (To search for a specific CFR, visit the Code of Federal Regulations.)
Legal Authority: PL 111-148   
Legal Deadline:  None
Timetable:
Action Date FR Cite
Interim Final Rule  07/23/2010  75 FR 43330   
Interim Final Rule Effective  09/21/2010    
Second Interim Final Rule  06/00/2011    
Regulatory Flexibility Analysis Required: Undetermined  Government Levels Affected: Undetermined 
Federalism: Undetermined 
Included in the Regulatory Plan: No 
RIN Data Printed in the FR: No 
Agency Contact:
Ellen Kuhn
Department of Health and Human Services,
Department of Health and Human Services
Centers for Medicare & Medicaid Services
7500 Security Boulevard,
Baltimore, MD 21244
Phone:301 492-4100
Email: externalappeals@hhs.gov