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EBSA/OIG Shows Path Out of Forest for Patients, Plans and Service Providers
AVYM Healthcare Revenue Consultants
Dec. 21, 2016 "EBSA offers guidance for denied health care benefit claims after OIG reports EBSA did not have the ability to protect the estimated 79 million plan participants in self-insured health plans from improper denials of health claims.... EBSA is advocating for new 5500 Schedule J reporting requirements to include a range of claims payment data ... [It] appears the EBSA is providing guidelines or possible 'Red Flags' for possible investigations into violations.... EBSA has made it clear that it is committed to conducting focused yet robust health investigations that seek global corrections of violations in order to restore losses to participants who were harmed." MORE >> |
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