Recommended Preventive Services for Women

The Institute of Medicine has released its report that includes recommended preventive services for women be added to the services that health plans will cover at no cost to patients under Public Health Service Act Sec. 2713, as added by the Patient Protection and Affordable Care Act of 2010 (PPACA).

For information please visit:
http://www.iom.edu/Reports/2011/Clinical-Preventive-Services-for-Women-Closing-the-Gaps.aspx.

New Guidance Available for Early Retirement Reinsurance Program

The Centers for Medicare and Medicaid Services has published supplemental program guidance and has updated existing program guidance under the Early Retiree Reinsurance Program (ERRP).

• These codes have also been added to the downloadable CSV file on the Regulations and Guidance page at http://www.errp.gov.
• The additional ineligible proceduresare listed at http://www.errp.gov/download/ERRP_Additional_Ineligible_ Procedures_and_Diagnoses.pdf.

EBSA Issues Amendments to Interim Final Rules and Model Notices on Internal Claims and Appeals and External Review Processes

For more information please visit:
http://www.gpo.gov/fdsys/pkg/FR-2011-07-26/pdf/2011-18820.pdf.

Additional information and model notices also available here:

• Technical Release 2011-02
• Revised Model Notice of Adverse Benefit Determination.
• Revised Model Notice of Final Internal Adverse Benefit Determination.
• Revised Model Notice of Final External Review Decision.