Health Reform Law for Claims & Appeals: July 1, 2011 - PPACA Enforcement Date For Provider’s Bill Of Rights

Share Article Announced the Total PPACA Claims & Appeals Compliance Services for Doctors and Hospitals, to be Compliant by July 1, 2011, PPACA Enforcement Date, Including Education for PPACA Claims Specialists and PPACA Appeals Department, Claims Recovery, and Litigation Support.

July 1, 2011 is the enforcement date for the new Federal Providers Bill of Rights under Health Reform Laws

As July 1, 2011, the PPACA claims & appeals regulation enforcement date, is only 30 days away, announced the Total PPACA Claims & Appeals Compliance Services for doctors and hospitals, to be in compliance with new healthcare reform laws for all claims delays and denials for all group health plans and individual claim market. is the first and only PPACA Total Compliance Service Provider for healthcare providers with complete spectrum of educational and consulting services, including education and implementation for PPACA claims specialists and PPACA appeals department, claims recovery and litigation support, for billing coding staff, supervisor, manager, director, CFO, in-house counsel and outside billing companies as well as outside litigating attorneys. PPACA claims and appeals regulations are the most sweeping reimbursement law changes since the enactment of Medicare 45 years ago.

“July 1, 2011 is the enforcement date for the new federal Providers Bill of Rights under Health Reform Laws”, says Dr. Jin Zhou, President of, a national expert on PPACA and ERISA appeals and compliance.

On March 23, 2010, President Obama signed into law the Health Reform Bill, PPACA (Patient Protection and Affordable Care Act). PPACA claims and appeals regulations went into effect on September 23, 2010. PPACA adopts ERISA claim regulation in its entirety, with 7 new requirements, as the minimum PPACA internal appeal standards. PPACA adopts NAIC external appeal model, with 16 new standards, as PPACA federal and state external appeal standards.

On September 20, 2010, the Departments, DOL, HHS & IRS, issued a Technical Release (TR #2010-02) to extend enforcement grace period until July 1, 2011 for certain new PPACA internal appeal standards. Also, during enforcement grace period, no enforcement actions will be taken against a plan that is working in good faith to implement such additional standards but does not yet have them in place.

On March 18, 2011, the Departments issued another Technical Release (TR # 2011-01) to extend enforcement grace period, in part only for three new standards, until January 1, 2012, which are insignificant for healthcare providers. The TR #201101 seeks to minimize both cost and delay, to avoid confusion for participants and plans alike, and to avoid enforcing standards that the Departments intend to modify in the near future.

Both technical releases do not affect disclosure requirements still in effect for ERISA plans under ERISA claims procedure regulation for 36 years, and do not address the rights of private parties in private litigation by healthcare providers.

If a plan fails to comply with PPACA claims regulations, $100/patient/day, a excise tax liability should be reported on IRS Form 8928 with respect to PHS Act section 2719(b) with respect to a failure to meet any of these particular standards

More importantly, July 1, 2011, the PPACA claims and appeals enforcement date, will start the enforcement for the new federal Provider’s Bill Of Rights, as PPACA claims regulation defines a health care provider, with a valid designation of authorized representative, as a claimant, regardless of network participation. This new federal law will make the new federal Patient’s Bill of Rights same as the new federal Provider's Bill of Rights in U.S. healthcare history.

Complete PPACA Regulations and Guidance can be found on DOL website:

Since the enactment of PPACA on March 23, 2010, has offered the Total PPACA Claims & Appeals Compliance Services for doctors and hospitals, including, but not limited to, the followings:

1.    PPACA Webinars for Hospital CFOs: Most Sweeping Health Reform Revenue Laws & "Overpayment" Crisis - 04-26-2011
2.    PPACA Claims Specialist: YF Corporation Makes History In Advocating Patient’s Bill Of Rights For Claims Denials - 04-25-2011
3.    Courts' Million-Dollar ERISA Decision Against Hospital Prompts Million-Dollar PPACA Claims Recovery Services - 04-24-2011
4.    Healthcare Reform Law PPACA Claim Specialists: New Legal Assignment of Benefits Required Under New Federal Provider’s Bill of Rights - 01-17-2011
5.    Federal PPACA Claim Laws for Out-of-Network Doctors & Hospitals – Same Rights as In-Network Providers - 04-18-2011
6.    Healthcare Reform Law PPACA Claim Specialists: New Legal Assignment of Benefits Required Under New Federal Provider’s Bill of Rights - 01-17-2011
7.    First National Healthcare PPACA & ERISA Claims Specialist Certification Class Under Health Reform Laws Held For Provider State Association - 11-22-2010
8.    Webinars On New Federal Penalties In $100 / Day / Patient On Insurers, HMO’s, TPA’s & IRO’s Under External Review Laws, Effective Sept. 23, 2010 Per IRS, DOL & HHS - 08/30/2010
9.    New Health Reform Law Claim Denial Appeal Book Announced for Healthcare Providers to Comply with New PPACA Deadline: 09/23/2010 - 06/28/2010
10.    New Health Reform Law Appeal Certification Class Announced for Hospitals to Comply with New PPACA Deadline: 09/23/2010 - 06/24/2010
11. Webinars On Healthcare Revenue Cycle Crisis Turnaround: Pre-Payment Review Delays and Denials – Deemed Denial ERISA Appeals - 04/19/2010

To find out more about the Total PPACA Claims and Appeals Compliance Services from

Located in a Chicago suburb in Illinois, is the only ERISA & PPACA consulting, publishing and website resource for healthcare providers in the country. offers free webinars, basic and advanced educational seminars and on-site claims specialist certification programs for doctors, hospitals and commercial companies, as well as litigation support. Dr. Jin Zhou is regarded as the industry “Godfather of ERISA claims” for healthcare providers.

For any questions, please contact Dr. Jin Zhou, president of, at 630-808-7237.


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