{"abstract":"This document contains interim final regulations implementing the requirements regarding internal claims and appeals and external review processes for group health plans and health insurance coverage in the group and individual markets under the Patient Protection and Affordable Care Act. The regulations will generally affect health insurance issuers; group health plans; and participants, beneficiaries, and enrollees in health insurance coverage and in group health plans. The regulations provide plans and issuers with guidance necessary to comply with the law.","action":"Interim final rules with request for comments.","agencies":[{"raw_name":"DEPARTMENT OF THE TREASURY","name":"Treasury Department","id":497,"url":"https://www.federalregister.gov/agencies/treasury-department","json_url":"https://www.federalregister.gov/api/v1/agencies/497","parent_id":null,"slug":"treasury-department"},{"raw_name":"Internal Revenue Service","name":"Internal Revenue Service","id":254,"url":"https://www.federalregister.gov/agencies/internal-revenue-service","json_url":"https://www.federalregister.gov/api/v1/agencies/254","parent_id":497,"slug":"internal-revenue-service"},{"raw_name":"DEPARTMENT OF LABOR","name":"Labor Department","id":271,"url":"https://www.federalregister.gov/agencies/labor-department","json_url":"https://www.federalregister.gov/api/v1/agencies/271","parent_id":null,"slug":"labor-department"},{"raw_name":"Employee Benefits Security Administration","name":"Employee Benefits Security Administration","id":131,"url":"https://www.federalregister.gov/agencies/employee-benefits-security-administration","json_url":"https://www.federalregister.gov/api/v1/agencies/131","parent_id":271,"slug":"employee-benefits-security-administration"},{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"}],"body_html_url":"https://www.federalregister.gov/documents/full_text/html/2010/07/23/2010-18043.html","cfr_references":[{"chapter":null,"citation_url":null,"part":54,"title":26},{"chapter":null,"citation_url":null,"part":602,"title":26},{"chapter":null,"citation_url":null,"part":2590,"title":29},{"chapter":null,"citation_url":null,"part":147,"title":45}],"citation":"75 FR 43330","comment_url":null,"comments_close_on":null,"correction_of":null,"corrections":[],"dates":"Effective date. These interim final regulations are effective on September 21, 2010.","disposition_notes":null,"docket_ids":["TD 9494","OCIIO-9993-IFC"],"dockets":[],"document_number":"2010-18043","effective_on":"2010-09-21","end_page":43364,"executive_order_notes":null,"executive_order_number":null,"explanation":null,"full_text_xml_url":"https://www.federalregister.gov/documents/full_text/xml/2010/07/23/2010-18043.xml","html_url":"https://www.federalregister.gov/documents/2010/07/23/2010-18043/interim-final-rules-for-group-health-plans-and-health-insurance-issuers-relating-to-internal-claims","images":{},"images_metadata":{},"json_url":"https://www.federalregister.gov/api/v1/documents/2010-18043?publication_date=2010-07-23","mods_url":"https://www.govinfo.gov/metadata/granule/FR-2010-07-23/2010-18043/mods.xml","not_received_for_publication":null,"page_length":35,"page_views":{"count":8487,"last_updated":"2026-04-04 18:15:03 -0400"},"pdf_url":"https://www.govinfo.gov/content/pkg/FR-2010-07-23/pdf/2010-18043.pdf","presidential_document_number":null,"proclamation_number":null,"public_inspection_pdf_url":null,"publication_date":"2010-07-23","raw_text_url":"https://www.federalregister.gov/documents/full_text/text/2010/07/23/2010-18043.txt","regulation_id_number_info":{"0991-AB70":{"issue":"201010","html_url":"https://www.federalregister.gov/regulations/0991-AB70/group-health-plans-and-health-insurance-issuers-relating-to-internal-claims-and-appeals-and-external","title":"Group Health Plans and Health Insurance Issuers Relating to Internal Claims and Appeals and External Review Processes Under the Patient Protection and Affordable Care Act","xml_url":"http://www.reginfo.gov/public/do/eAgendaViewRule?pubId=201010&RIN=0991-AB70&operation=OPERATION_EXPORT_XML","priority_category":"Economically Significant"},"1545-BJ63":{"issue":"201010","html_url":"https://www.federalregister.gov/regulations/1545-BJ63/appeals-under-the-patient-protection-and-affordable-care-act","title":"Appeals Under the Patient Protection and Affordable Care Act","xml_url":"http://www.reginfo.gov/public/do/eAgendaViewRule?pubId=201010&RIN=1545-BJ63&operation=OPERATION_EXPORT_XML","priority_category":"Substantive, Nonsignificant"},"1210-AB45":{"issue":"201104","html_url":"https://www.federalregister.gov/regulations/1210-AB45/group-health-plans-and-health-insurance-issuers-relating-to-internal-and-external-appeals-processes-","title":"Group Health Plans and Health Insurance Issuers Relating to Internal and External Appeals Processes Under the Patient Protection and Affordable Care Act","xml_url":"http://www.reginfo.gov/public/do/eAgendaViewRule?pubId=201104&RIN=1210-AB45&operation=OPERATION_EXPORT_XML","priority_category":"Other Significant"}},"regulation_id_numbers":["0991-AB70","1210-AB45","1545-BJ63"],"regulations_dot_gov_info":{"checked_regulationsdotgov_at":"2010-08-12T11:25:31Z"},"regulations_dot_gov_url":null,"significant":true,"signing_date":null,"start_page":43330,"subtype":null,"title":"Interim Final Rules for Group Health Plans and Health Insurance Issuers Relating to Internal Claims and Appeals and External Review Processes Under the Patient Protection and Affordable Care Act","toc_doc":"Internal Claims and Appeals and External Review Processes under the Patient Protection and Affordable Care Act","toc_subject":"Group Health Plans and Health Insurance Issuers:","topics":["Employee benefit plans","Excise taxes","Health care","Health insurance","Pensions","Reporting and recordkeeping requirements"],"type":"Rule","volume":75}