A project of the George Washington University's Hirsh Health Law and Policy Program and the Robert Wood Johnson Foundation

New rules make it easier for public to appeal denials of health insurance claims

Posted on July 22, 2010 | Comment (1)

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On July 22nd, new rules were issued easing patients’ ability to appeal health insurance claim denials. The new regulations guarantee that patients can appeal denials directly to insurers and then to an external review board, if necessary.

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The right to a fair and impartial appeal when a group health plan or health insurer denies a claim would seem to be a basic matter of fairness. Historically, however, this has not been the case. Patient protections vary tremendously depending on the type of health insurance and federal and state legal requirements.