USHealthcareCrisis.com

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	U.S. Healthcare Crisis Turnaround?
	U.S. A.	Drs. & Hospitals	Employers
	$1.0 Trillion / Year	$$$ ERISA $$$	50% Savings
The Only Company with Compliant Solutions for All of You

03/23/2010

Breaking News

 

President Obama Signed Into the Law the Healthcare Legislation to Revamp Healthcare Reimbursement Laws for All Group Health Plans and Health Care Providers

 

The Final Health Reform Bill Has Been Signed By President Obama Into The Law Of The Land For More Than 95% Americans, As The Most Significant Changes Since Medicare Was Created 45 Years Ago. What Does Obama Healthcare Law Mean To Healthcare Providers And Health Plans? The New Federal Reimbursement Laws Protect Health Care Providers with ERISA Internal And External Appeals, Extended Disclosure And Appeal Rights, New Federal UCR Fee Centers And New Federal Simplified, Uniform Standards For Claim Processing And Appeals. The New Federal Reimbursement Laws Will Eventually Eliminate Most Managed care Abuses

 

New Federal Health Claims & Appeals Laws & Regulations for 193 Million Americans Effective 09-23-2010 ©2010, Jin Zhou, ERISAclaim.com
President Obama Signing Health Bill on 03/23/2010		President Gerald R. Ford Signing ERISA on 09/02/1974
New Webinars, Seminars & Certification Classes Announced for New Federal Health Claim Appeals Regulations on July 22, 2010 from HHS, DOL & IRS, Effective On Sept. 23, 2010 for 193 Million Americans
	UNITED STATES DEPARTMENT OF LABOR (Links to DOL) ©2010, Jin Zhou, ERISAclaim.com
Patient Protection and Affordable Care Act Statutory Laws [PDF] [PDF]   Affordable Care Act Regulations and Guidance Regulations on Internal Claims and Appeals and External Reviews: Interim Final Rule • Amendment to IFR • Corrections •  NAIC Uniform External Review Model Act  • News Release • Fact Sheet •  Public Comments Guidance, EOB’s & FAQ’s: TR11-02 • TR11-01 • TR10-02 • TR10-01 • EOB1 • EOB2 • EOB3 • FAQ I • FAQ II • FAQ III •  FAQ IV •  FAQ V • FAQ VI •  Consumer Assistance Programs Grandfathered Health Plans: Regulation •  Fact Sheet on Regulation • FAQ’s •  Summary Chart • Model Notice •  Amendment to IFR • Fact Sheet on Amendment Preexisting Condition Exclusions, Lifetime and Annual Limits, Rescissions, and Patient Protections: Regulation • Fact Sheet • Patient Protection Model Notice • Lifetime Limits Model Notice • Dependents Model Notice  Extension of Coverage For Adult Children:  Regulation •  Fact Sheet • FAQs • IRS Guidance FAQs on Health Care Reform and COBRA   Affordable Care Act Compliance Assistance Webcast Series Archive: Part I • Part II House Committees Health Insurance Reform at a Glance: Summary • Implementation Timeline • Consumer Protections • For Employers White House Web Page on Health Reform HHS Health Reform Web Site
Employee Retirement Income Security Act — ERISA
ERISA Claims Regulation - 29 CFR 2560.503-1: Regulation • FAQ • Fact Sheet • Claims Guide • Claims Card ERISA SPD Regulation - 29 CFR 2520.102-3: Amendments to Summary Plan Description Regulations • Fact Sheet • News Release • SPD Rights Fact Sheet • SPD from DOL   Health Claims Related Information Consumer Information on Health Plans Compliance Assistance for Health Plans •  Fiduciary Guide Health Benefits Education Campaign
Webinars, Seminars & Certification Classes for New Federal Health Claim Appeals Regulations   ERISAclaim.com - Free Webinars - New Federal Claims & Appeals Regulations, Effective Sept. 23, 2010, for 193 Million Americans   ERISAclaim.com: Seminars - 2011 Two-day Basic ERISA Appeal Seminars - Denials and Overpayment Appeals   ERISAclaim.com - 2011 PPACA & ERISA Claim Specialist Certification Programs in Chicago, Illinois   ERISAclaim.com:  Create An Appeal Department for Your Hospital or Practice (In-house, onsite ERISA Claim Specialist Certification Programs)

 

Welcome

 

ERISAclaim.com with its principal and founder, Dr. Jin Zhou, is committed to providing unique and practical solutions to our nation's health care crisis, in case the Congress and the President of the United States fail to stop our health-care crisis, probable health care crash and future federal budget deficits of $44.2 trilion;

 

We will provide educational and consulting solutions to healthcare providers, clinics and hospitals for maximum reimbursement or crisis turnaround only through compliance of ERISA;

We will provide educational and consulting solutions to employers/plan sponsors, insurers and TPA's with compliance assistance to minimize administrative costs and risks through compliance of ERISA;

 

We will provide educational and consulting solutions to the nation to establish or restore the hope, faith and the Law & Order  for our health-care system through education and compliance of ERISA, the federal law designed to regulate about 80% of the health-care claims and 60% of the U.S. health-care expenditure, ERISA is the only "nuclear power" capable of stopping our escalating health-care costs. Compliance is the only common ground for everyone, and it is the only way that we can bail out of our worst health-care crisis since World War II.

 

Our strategy is to solve US health-care crisis through:

 

1. Scientific identification of the most accurate causation for skyrocketing medical inflation and fundamental failure of US health care delivery system - ERISA Failure;

2. Identification of common ground for everyone involved, governing federal law for employer-sponsored health-care system that has been already on the book for the past 30 years - ERISA; and

3. Providing a solution to

 

ü     Establish Prudent "Personal Responsibility" without Eliminating Employer-Sponsored Health-Care System and without "Skipping Necessary Health Care" and "Personal Bankruptcy";

ü      Keep Employer-Sponsored Health-Care System with Quality Health Care but without Skyrocketing Medical Cost Disaster.

Our mission is to prevent another "Failure of Imagination" in US healthcare crisis triggered economic recession or even disaster, and "John Q. ERISA Enforcement"!

 

 

New Webinars, Seminars & Certification Classes Announced for New Federal Health Claim Appeals Regulations on July 22, 2010 from HHS, DOL & Treasury    08/05/2010, Hanover Park, IL

New Webinars, Seminars & Certification Classes Were Announced by ERISAclaim.com for New Federal Appeals Regulations Issued on July 22, 2010 by HHS, DOL & Treasury for 193 million Americans. Effective 09/23/2010, New Federal Reimbursement Laws Mandate ERISA Internal Appeals and NAIC External Appeals For All Group and Individual plans With Six New & Most Powerful Consumer Protections

 

ERISAclaim.com - 2009 - 2010 Claim Denial & Overpayment Dispute Two-day ERISA Appeal Seminars,   ERISAclaim.com - 2010 ERISA Claim Specialist Certification Programs in Chicago, Illinois   New ERISA Appeal Book with 2010 Major Updates  $450  & $150 (Updates only with previous purchase)   ERISAclaim.com - ERISA Litigation Support, Facts + Laws + Strategies = Winning Lawsuit When Inevitable   ERISAclaim.com - Free ERISA Webinar, The Beginning for $6 Trillion Healthcare Denial Management Market   ERISAclaim.com Press Release   ERISAclaim.com Announced the Nation's First Certification Program for the ERISA Claim Appeal Specialist for Healthcare Providers and Managed-Care Payers, 10-13-2009, Hanover Park, IL   ERISAclaim.com Announced 2010 ERISA Seminars for Healthcare Overpayment and Claim Denial Appeals for the $6 Trillion Healthcare Denial Management Market. 10-14-2009, Hanover Park, IL

 

 

Unanimous US Supreme Court Ruling In US Health Care Crisis by Jin Zhou, 02/11/2005 © 2005, Jin Zhou, ERISAclaim.com Managed-Care Nightmares? Health-Care Crisis without True Solutions?   What Does an Unanimous US Supreme Court Say?   On June 21, 2004, an unanimous US Supreme Court ruled that claim processing and denials of benefits under the employer-sponsored health plans, ERISA-regulated benefit plans, for both self-insured and fully-insured (through purchase of insurance) health plans, are completely governed by federal law ERISA, that supersedes and invalidates state laws.   How Can Anyone in USA, from Congress to General Motor to the White House, from Industry Experts to Patient Advocates, Solve US Health Care Crisis without Even Thinking of ERISA? "Failure of Imagination" As a Nation Is the Real Tragedy   ERISAclaim.com - Supreme Court Managed Care ERISA Watch   Unanimous US Supreme Court Ruling In US Health Care Crisis   Aetna Health Inc. v. Davila 06/21/04 Opinion of the Court   "Held: Respondents’ state causes of action fall within ERISA§502(a)(1)(B), and are therefore completely pre-empted by ERISA §502 and removable to federal court. Pp. 4–20."   "We hold that respondents’ causes of action, brought to remedy only the denial of benefits under ERISA-regulated benefit plans, fall within the scope of, and are completely pre-empted by, ERISA §502(a)(1)(B), and thus removable to federal district court. The judgment of the Court of Appeals is reversed, and the cases are remanded for further proceedings consistent with this opinion.7 It is so ordered."

 

Discount for March 2005: $35   $450 ERISA CD Book ERISA Claim Appeal Books & Systems Click here or the CD-Picture to enter our Secured Online Order page

With New 2005 Update (including New ERISA Assignment Form Required for ERISA Appeals, DOL, FAQ, B2-3)

 

ERISA Failure Syndrome U.S. Healthcare Crisis Trilogy (Copyright © 2004 by Jin Zhou,  ERISAclaim.com)
ERISA Medical Killing		ERISA Medical Inflation		ERISA Insurance Robbery
	?   ?		?   ?		GAO-04-312 ? ?
American Job ExportING!		Mass layoffs up in January 2004		Weirton Steel cancels 10,000 GM: $67.5 billion in 2003
The Looming National Benefit Crisis (USATODAY.com) One Nation under Debt: U..S. economy threatened by aging of America NATIONAL DEBT COLLISION COURSE MEDICARE CALCULATOR METHODOLOGY ►HIDDEN COSTS ►DEMOGRAPHICS ►RISING COSTS ►YOUR SHARE ►EXPLAINOR   Healthcare Disaster at Fault Verdict Index: U.S. Government 30% U.S. Employers & Insurers 30% Healthcare Providers 30% Consumers 10% (ERISA Failure + Managed-Care) Destroyed US Healthcare (ERISA Failure + Managed-Care + HSA) Invite US Federal Budget Deficit & Social Security Disasters = 100X 9/11 Attacks   GAO: Current and Emerging Fiscal and Retirement Security Challenges, American Benefits Council/MetLife Conference, Washington, DC, on January 14, 2005 Rising Health care Costs Have Many Implications (Direct) Rising Healthcare Costs Have Many Implications (Indirect)   Rx-1  $$$$$$$$$ERISA$$$$$$$$$$  Rx-2

Happy or Sad 30th Birthday To ERISA? (Copyright © 2004 by Jin Zhou,  ERISAclaim.com) Sept. 2, 2004 On Sept. 2, 1974, exactly 30 years ago today, ERISA, The Employee Retirement Income Security Act, was signed into law by President Gerald R. Ford. The congressional intent in enacting ERISA was to protect employees in pension and welfare plans, to provide uniform federal protections in response to the failure of the Studebaker Co. in December 1963, with thousands of long-service employees cheated out off their promised pensions, and to preempt any state laws when the employees pension and welfare benefits were threatened. 30 years later, ERISA Failure in its compliance and enforcement left thousands of retirees without medical benefits, and resulted in a skyrocketing national healthcare expenditure explosion with 45 million uninsured and a possible national pension bailout. ERISA Failure Syndrome U.S. Healthcare Crisis Trilogy   Jin Zhou Identifies "ERISA Failure" That Killed U.S. Healthcare "Failure of Imagination" Again?     Statement by President Gerald R. Ford Upon Signing the Employee Retirement Income Security Act of 1974

ERISA Celebrates 30th Anniversary As Trouble Brews For the Pension Insurance Program (Spencer Benefits Reports) Excerpt: "The seed for ERISA was planted with the failure of the Studebaker Company in December 1963, leaving thousands of long-service employees without their promised pensions."

Claim Recovery	Appeal Books	Seminars	Consulting
Reimbursement Crisis? Contingency Recovery Service for Dead, Difficult  and Hopeless Accounts from Denied Medical/ERISA Claims In past 3 Years, This Could Be up to 20-40% of Your Revenue.	The Most Powerful & only Book in the U.S. Focused on Health Care ERISA Claim Denials & Appeals   for Health Care Providers, Physicians, Clinics and Hospitals. (2003 Update Free Download)	We now offer post-seminar teleconference for staff training at $190/hour. The Most Powerful & only Seminar in the U.S. Focused  on Health Care ERISA Claim Denials & Appeals   Stop Managed Care Abusive Claim Delays & Denials! Getting Paid with New Federal Claim (ERISA) Rules	Maximal Reimbursement or Crisis Turnaround to Get Paid!   Concentrating on ERISA Healthcare Claim Denials And Appeals When Traditional and Conventional Appeal Procedures All Failed  Because ERISA Preempts Your State Laws.
ERISA OVERHAUL OF U.S. HEALTHCARE FOR SURVIVAL   "Zhou's Model of Prudent Health Care" Are All Consultants Corrupt? (Fast Company) USA: GM chief talks health care as Republicans convene: Auto News "Wagoner reportedly said much of the discussion in Washington tends to centre around a complete, free-market system on one extreme, and a national health care programme [similar to the UK’s National Health Service] on the other.   "I suspect we're not going to end up with either one of those solutions," he told the Associated Press. "So if we could get people working on stuff in the middle ... I think there'd be some real improvements made."         Jin Zhou Identifies "ERISA Failure" That Killed U.S. Healthcare "Failure of Imagination" Again?   ASO+HMO+PPO-SPD=$1.8 Trillion/Y US Healthcare Crisis   ERISA+SPD-HMO-PPO-ASO=50% Savings   The First Overhaul for U.S. Health care and GM Is to ERISA-Overhaul GM Health Care Model with Followings: ERISA Compliant SPD with Complete Benefits Coverage, Limits & Exclusions; ERISA Compliant Claims Procedure as the Only Rule for Every One; Elimination of Any Third-Party Managed Care Contracts, UCR & "Medical Necessity" GM Current Model: $5.1 billion/yr, $1,400/vehicle) (GM says health care obligation hit $67.5 billion in 2003) Rx-1  $$$$$$$$$ERISA$$$$$$$$$$  Rx-2 Health Spending Projections Through 2013 New Federal Claim Regulation (Final Rule) Benefit Claims Procedure Regulation (FAQ) Amendments to Summary Plan Description Regulations (Final Rule) Patient's Rights Claims Procedure Regulation (Fact Sheet) U.S. Health-care Crisis & ERISA Criminal Enforcement CBO's analysis of the President's budgetary proposals for fiscal year 2005 Fact Sheet: Affordable Health Care for America's Families (White House)   Zhou's Medical Inflation Projection Through 2008: $1,000 Deductible (HDHP / HSA) + $1,500 Discount (HHS / Indigence) [Deductible + UCR + PPO Disc.]  =  "Discretionary Spending" + "Price Gouging" =   500% Medical Inflation in 5 years    DOL-Reporting and Disclosure Guide for Employee Benefit Plans (pdf) Compliance Assistance for Group Health Plans (Top 15 Tips) 950,000 MD's Settled With Aetna & Cigna on ERISA "Aetna and CIGNA Settlement Secrets" ERISA Certification Programs for Maximal Reimbursement What You Should Know about Filing Your Health Benefits Claim HIPAA Nondiscrimination Requirements Frequently Asked Questions