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Code · STATUTE-COMPILATIONS · Patient Protection and Affordable Care Act · Sec. 1562

Sec. 1562. GAO STUDY REGARDING THE RATE OF DENIAL OF COVERAGE AND ENROLLMENT BY HEALTH INSURANCE ISSUERS AND GROUP HEALTH PLANS

360 words·~2 min read·/statute-compilations/comps-9307/sec-1562

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## SEC. 1562 GAO STUDY REGARDING THE RATE OF DENIAL OF COVERAGE AND ENROLLMENT BY HEALTH INSURANCE ISSUERS AND GROUP HEALTH PLANS ###
(a)In General The Comptroller General of the United States (referred to in this section as the “Comptroller General”) shall conduct a study of the incidence of denials of coverage for medical services and denials of applications to enroll in health insurance plans, as described in subsection (b), by group health plans and health insurance issuers. ###
(b)Data ####
(1)In general In conducting the study described in subsection (a), the Comptroller General shall consider samples of data concerning the following: #####
(A)######
(i)denials of coverage for medical services to a plan enrollees, by the types of services for which such coverage was denied; and ######
(ii)the reasons such coverage was denied; and #####
(B)######
(i)incidents in which group health plans and health insurance issuers deny the application of an individual to enroll in a health insurance plan offered by such group health plan or issuer; and ######
(ii)the reasons such applications are denied. ####
(2)Scope of data #####
(A)Favorably resolved disputes The data that the Comptroller General considers under paragraph
(1)shall include data concerning denials of coverage for medical services and denials of applications for enrollment in a plan by a group health plan or health insurance issuer, where such group health plan or health insurance issuer later approves such coverage or application. #####
(B)All health plans The study under this section shall consider data from varied group health plans and health insurance plans offered by health insurance issuers, including qualified health plans and health plans that are not qualified health plans. ###
(c)Report Not later than one year after the date of enactment of this Act, the Comptroller General shall submit to the Secretaries of Health and Human Services and Labor a report describing the results of the study conducted under this section. ###
(d)Publication of Report The Secretaries of Health and Human Services and Labor shall make the report described in subsection
(c)available to the public on an Internet website.
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