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Affordable Care Act (Health Care Reform)

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Submitted By xtalreilly27
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Legal Methods and Process

The Affordable Care Act ensures your right to appeal health insurance plan decisions which is when you ask that your plan to reconsider its decision to deny payment for a service or treatment. New rules that apply to health plans created after March 23, 2010 spell out how your plan must handle your appeal (usually called an “internal appeal”). If your plan still denies payment after considering your appeal, the law permits you to have an independent review organization decide whether to uphold or overturn the plan’s decision. This final check is often referred to as an “external review.” Many states offer help to consumers with health insurance problems. The Affordable Care Act improves these services with grants that help states start or strengthen Consumer Assistance Programs (CAPs). The states and territories that applied for these grants have received funds provide residents direct help with problems or questions about health coverage. Whether or not your state has a Consumer Assistance Program, you have rights under the health care law, including the right to appeal decisions made by your health insurance provider. If your state does not have a Consumer Assistance Program, some state and federal government offices may still be able to help you determine your rights and solve problems. Florida does not operate a Consumer Assistance Program under the Affordable Care Act. The new consumer protections and benefits of the law still apply to Joe. In the State of Florida the first place Joe would go would be the Florida Office of Insurance Regulation in Tallahassee. Here Joe can find out what information he needs, file a complaint, or find out if there is any other insurance or programs that he qualifies for. They can also help him find more protections and benefits that suit his needs. If Joe’s denial was

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