Health Administration Responsibility Project

Federal Statutes and Regulations


Statutes

Health Maintenance Organization Act of 1973
Employee Retirement Income Security Act of 1974
Medicare US CODE sections
EMTALA (anti-dumping law)
COBRA (health insurance continuation)
HIPAA (privacy) ... HIPAA Answers ... HHS Office for Civil Rights
HR 3590, Patient Protection and Affordable Care Act of 2010

Regulations

ERISA Regulations, 29 CFR Chap. XXV
29 CFR 2560.503-1: New ERISA Claims Regs Eff. 7/1/2002
DOL EBSA website map
Medicare and Medicaid, 42 CFR Chap. IV
Medicare Appeals Regulations
HIPAA privacy regulations
45 CFR 164.524 HIPAA Reg re Access of Individuals to their own protected health information
Federal Rules restricting Physician Incentive Plans in Medicare/aid HMOs

Manuals

Medicare Appeals Manual
Medicare/Medicaid On-Line Manuals

Your right to see ERISA Plan documents

Under 29 USC 1021, the Administrator must furnish copies of the Summary Plan Description (SPD) and the Annual Report.
Under 29 USC 1024(b)(2) he must make available for inspection the SPD with all modifications and changes, the annual report, and the contract or agreement under which the plan was established, and upon request furnish copies of the above.
Under 29 USC 1132(c)(1)(B), if he doesn't comply, after 30 days he is liable for a fine of $100/day.



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