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HHS/OCIIO RIN: 0950-AA01 Publication ID: Spring 2011 
Title: Internal Claims, Appeals, and External Review Processes Under the Affordable Care Act 
Abstract: The Affordable Care Act provides consumers with the right to appeal decisions made by their health carrier to an outside, independent decisionmaker, regardless of 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 regulations and provide an opportunity to respond to public comments. 
Agency: Department of Health and Human Services(HHS)  Priority: Other Significant 
RIN Status: Previously published in the Unified Agenda Agenda Stage of Rulemaking: Completed Actions 
Major: No  Unfunded Mandates: No 
CFR Citation: 45 CFR 147   
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 Comment Period End  09/21/2010    
Interim Final Rule Effective  09/21/2010    
Merged With 0938-AQ66  02/11/2011    
Regulatory Flexibility Analysis Required: No  Government Levels Affected: State 
Federalism: Yes 
Included in the Regulatory Plan: No 
RIN Data Printed in the FR: No 
Agency Contact:
Ellen Kuhn
Program Analyst
Department of Health and Human Services
200 Independence Avenue SW.,
Washington, DC 20201
Phone:301 492-4100
Email: externalappeals@hhs.gov