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Internal Claims and Appeals and External Review under Health Care Reform (PDF)
Practical Law Publishing Limited and Practical Law Company, Inc. via Groom Law Group 
[Guidance Overview] Sept. 8, 2011 The Amendments clarify that plans or insurers must provide benefits following a final external review decision without delay. A plan or insurer cannot refuse to provide benefits on the grounds that it intends to challenge the decision in court. However, a court decision contrary to the final external review decision would be a basis for not providing benefits. MORE >> |
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