Alert / Employee Benefits
Nonfederal government plans: Online portal address updated for federal appeals

Health plans that use the federal external appeals process must update notices pursuant to a recent Department of Health and Human Services (HHS) notice. Nonfederal government-sponsored health plans must use either an Affordable Care Act-compliant state external appeals process or the federal HHS-administered external review option for health plan appeals. Note, this requirement does not apply to grandfathered health plans that do not offer external appeals. 

When these health plans use the federal external appeals process, notice must be given to most participants after they exhaust internal appeals. Notice to participants must include all options for requesting federal external review, which include the following:

  • Email.
  • Mail.
  • Fax.
  • Online portal.

These notices must now be updated to add the new online portal address. The update requires a change of the address from externalappeal.gov to externalappeal.cms.gov.

Affected nonfederal government health plans should check with their insurers or third-party administrators to ensure external appeals notices are or will soon be properly updated.

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