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Guidance for ACOs/RBPOs 

This page is intended to provide additional guidance to risk-bearing provider organizations (RBPO) and accountable care organizations (ACO) establishing an appeals process pursuant to 958 CMR 11.00.

HPC Regulations and Guidance 

HPC’s final regulations and guidance as well as any currently proposed regulations and notices of public comment are listed below.

Submit an Inquiry 

OPP helps patients navigate the evolving health care system, assisting with a variety of issues that patients may face while accessing care.

Request an External Review of a Health Insurance Decision 

If your health insurance company recently denied your internal appeal, you may request an external review of that decision.

Request an External Review of a RBPO/ACO Decision 

If your provider organization recently denied your internal appeal, you may request an external review of that decision.

Request an Open Enrollment Waiver  

If you did not purchase health insurance during the last open enrollment period, you may still be eligible to sign up for or enroll in health insurance by requesting a waiver from the Office of Patient Protection (OPP).

HPC Research and Publications 

As part of its cost containment efforts and in fulfillment of the goals of Chapter 224, the HPC continually publishes reports, briefs, articles, and other research.

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