ERISA@41: ERISA & PPACA Claim Specialist & Litigation Support Services Announced from ERISAclaim.com

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On 09/2/2015, at ERISA’s 41st Birthday, “ERISA Godfather for Providers,” Dr. Jin Zhou, announced new ERISA hospital crisis turnaround programs: ERISA & PPACA claim specialist & in-house litigation support services from ERISAclaim.com

“ERISA internal and external appeals are prerequisites and vital to all judicial reviews in federal court, so ERISA appeals and litigation are intertwined and integrated for any court victories”, says Dr. Zhou.

On 09/2/2015, at ERISA’s 41st Birthday, “ERISA Godfather for Providers”, Dr. Jin Zhou, announced new ERISA hospital crisis turnaround programs: ERISA & PPACA claim specialist & in-house litigation support services from ERISAclaim.com. On Sep 02, 1974, Pres. Ford signed ERISA into law. On March 23, 2010, Pres. Obama signed PPACA into law. PPACA adopted ERISA in its entirety for all ERISA and Non-ERISA plans. PPACA creates ERISA Provider’s Bill of Right to appeal and sue in federal and state courts in order to advocate for patient ERISA & PPACA rights.

Happy ERISA@41! ERISAclaim.com passionately celebrates ERISA’s 41st birthday for advocating hard-working American workers’ ERISA and PPACA rights in order to protect them from the epidemic and escalating medical bankruptcies. Exactly 41 years ago today, Congress enacted ERISA, Employee Retirement & Income Security Act of 1974, to protect plan participants and beneficiaries for their pension and welfare rights, including healthcare benefits. The new ERISA hospital crisis turnaround programs, ERISA & PPACA Claim Specialist & In- House Litigation Support Services, are designed to ultimately protect all patients and their families from medical financial crises, especially when more and more hospitals are filing for bankruptcies with slow, low and no payment from their health plans.

“After almost 20 years in practicing ERISA advocacy, we have witnessed the best outcomes from our unique ERISA & PPACA advocacy programs, with combined in-house ERISA & PPACA Claims Specialists and ERISA Litigation Support for in-house ERISA attorneys,” says Dr. Jin Zhou, president of ERISAclaim.com, a national expert in ERISA and PPACA appeals and compliance, known by many as the “ERISA Godfather for Providers” in healthcare industry.

“ERISA internal and external appeals are prerequisites and vital to all judicial reviews in federal court, so ERISA appeals and litigation are intertwined and integrated for any court victories”, says Dr. Zhou.

As a birthday gift to ERISA@41, ERISAclaim.com offers these unique ERISA & PPACA advocacy programs, with the following important objections and goals, including but not limited to:

(A) Hospital and ASC Crisis Turnaround Specialist Training:
1.    Training of PPACA & ERISA Claims Specialist on the claims denials & appeals for all delayed and denied PPACA & ERISA claims, alleged overpayment recoupment and offset denials;
2.    Establishing hospital ERISA & PPACA Appeals & Litigation Department, with litigation support for the new in-house ERISA attorney(s);
3.    Training of HSA Claims Specialist, for today’s all new HDHP + HSA healthcare market: High Deductible Health Plan (HDHP) with Health Saving Account (HSA), to advocate for patient HSA rights, freedom of choice for in-network or out-of-network network quality care.

(B) PPACA Statutes Mandate ERISA Appeals Regulations For All Health Plans, ERISA and non-ERISA plans.

PUBLIC LAW 111 - 148 - Patient Protection and Affordable Care Act, SEC. 2719. APPEALS PROCESS: “(a) Internal Claims Appeals- `(2) ESTABLISHED PROCESSES- To comply with paragraph (1)`(A) a group health plan and a health insurance issuer offering group health coverage shall provide an internal claims and appeals process that initially incorporates the claims and appeals procedures (including urgent claims) set forth at section 2560.503-1 of title 29, Code of Federal Regulations, as published on November 21, 2000 (65 Fed. Reg. 70256), and shall update such process in accordance with any standards established by the Secretary of Labor for such plans and issuers” http://www.gpo.gov/fdsys/pkg/PLAW-111publ148/pdf/PLAW-111publ148.pdf

(C) ERISA & PPACA Claims Regulations – Patients & Providers Bills of Right:

PPACA regulations create a new definition of a Claimant to include a claimant’s authorized representative, and a new ERISA and PPACA right to sue, including a healthcare provider as a claimant’s authorized representative:

29 CFR Part 2590.715-2719 (DOL), 45 CFR Part 147.136 (HHS) & 26 CFR Parts 54.9815-2719AT and 602, (IRS) in part:

“Claimant. Claimant means an individual who makes a claim under this section. For purposes of this section, references to claimant include a claimant's authorized representative.”

“Deemed exhaustion of internal claims and appeals processes. ….. The claimant is also entitled to pursue any available remedies under section 502(a) of ERISA or under State law.”

“Minimum internal claims and appeals standards. A group health plan and a health insurance issuer offering group health insurance coverage must comply with all the requirements applicable to group health plans under 29 CFR 2560.503-1”
http://www.gpo.gov/fdsys/pkg/CFR-2014-title29-vol9/xml/CFR-2014-title29-vol9-sec2590-715-2719.xml
http://www.gpo.gov/fdsys/pkg/CFR-2014-title45-vol1/xml/CFR-2014-title45-vol1-sec147-136.xml
http://www.gpo.gov/fdsys/pkg/CFR-2014-title26-vol17/pdf/CFR-2014-title26-vol17-sec54-9815-2719T.pdf

To find out more about PPACA Claims and Appeals and Litigation Compliance Services from ERISAclaim.com: http://www.erisaclaim.com/products.htm

Located in a Chicago suburb in Illinois, for over 15 years, ERISAclaim.com is the only ERISA & PPACA consulting, publishing and website resource for healthcare providers in the country. ERISAclaim.com offers free webinars, basic and advanced educational seminars and on-site claims specialist certification programs for doctors, hospitals and commercial companies, as well as numerous pending national ERISA class action litigation support. Dr. Jin Zhou is regarded as the industry “Godfather of ERISA claims” for healthcare providers, and served as a consultant for the most recent provider ERISA class-actions in overpayment lawsuits with favorable decisions and permanent injunctions against health plans.

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

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Jin Zhou, President
ERISAclaim.com
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