Patient Protection and Mandatory External Review: Amending ERISA's Claims Procedure

Publication Date: January 2001

Publisher: Library of Congress. Congressional Research Service

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Research Area: Health

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Abstract:

This report discusses the existing claims procedure required by the Employee Retirement Income Security Act of 1974 (ERISA), and legislative efforts in the 106th Congress to amend ERISA to provide for the mandatory external review of denied benefits. Although most of the patient protection bills introduced in the 106th Congress included provisions for external review and more rigorous standards for the internal review of denied benefits, this report focuses on the Patients' Bill of Rights Plus Act of 1999, S. 1344, passed by the Senate on July 15, 1999, and the Bipartisan Consensus Managed Care Improvement Act of 1999, H.R. 2990, passed by the House of Representatives on October 7, 1999.