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Health Plan Appeal Rights in New York After the Affordable Care Act

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Posted: 27 Jul, 2012
by David Silva (New York Legal Assistance Group)
Updated: 13 Aug, 2021
by Valerie Bogart (New York Legal Assistance Group)

Samuel Salganik, an attorney at Community Health Advocates of the Community Services Society (CSS) wrote this incredibly thorough article breaking down the types of appeal rights available to individuals covered by the various types of private health insurance plans in New York.  This article includes coverage of the changes to patient protections wrought by the Affordable Care Act (ACA).

The article was originally published in the Winter 2012 edition of the New York State Bar Association Health Law Journal.

Some notations were added to the article on pp. 32 and 37 to indicate 2020-21 changes in NYS law affecting some of the rights described in the article.  Information provided by  CSS Community Health Advocates,

Attached files
item Appeals Paper final with 2021 updates - CSS.pdf (125 kb) Download

Also read
item Affordable Care Act --New York State Health Exchange Open Year-Round for Medicaid Applications and for Certain "Special Enrollment" categories
item "MAGI" Medicaid Eligibility under the Affordable Care Act - Rules for Most People Under age 65 Without Medicare

Also listed in
folder Private Insurance
folder Medicaid -> Appeals & Hearings

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