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Rules to ease consumer appeals in health coverage

USA Today, July 23, 2010

 

Consumers will get new and expanded rights to appeal denials of health insurance claims under federal regulations released Thursday. The rules, part of the nation's new health care law, will make it easier for consumers to dispute an insurer's decision within the plan and require coverage to continue during the appeal, said Phyllis Borzi, an assistant secretary in the Department of Labor. Consumers will have the right to an independent, third-party review of insurers' decisions. Although 44 states allow some form of external appeal, the level of consumer protection varies greatly, and in some states, the outside reviewer is hired by the insurer that denied the claim, Borzi said.