[20010119]RS20258_患者保护和强制性外部审查：修改ERISA的索赔程序.pdf

1 See Jean P. Hearne, Patient Protection and Managed Care: Legislation in the 106th Congress,CRS Issue Brief IB98017.2 See Hearne, supra note 1 (H.R. 2089 was offered as part of a package of eight other bills). On(continued.)Congressional Research Service ? The Library of CongressCRS Report for CongressReceived through the CRS WebOrder Code RS20258Updated January 19, 2001Patient Protection and Mandatory ExternalReview: Amending ERISAs Claims Procedurename redactedLegislative AttorneyAmerican Law DivisionSummaryThis report discusses the existing claims procedure required by the EmployeeRetirement Income Security Act of 1974 (ERISA), and legislative efforts in the 106thCongress to amend ERISA to provide for the mandatory external review of deniedbenefits. Although most of the patient protection bills introduced in the 106th Congressincluded provisions for external review and more rigorous standards for the internalreview of denied benefits, this report focuses on the Patients Bill of Rights Plus Act of1999, S. 1344, passed by the Senate on July 15, 1999, and the Bipartisan ConsensusManaged Care Improvement Act of 1999, H.R. 2990, passed by the House ofRepresentatives on October 7, 19