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’s final regulations and guidance as well as any currently proposed regulations and notices of public comment are listed below.
OPP helps patients navigate the evolving health care system, assisting with a variety of issues that patients may face while accessing care.
If your health insurance company recently denied your internal appeal, you may request an external review of that decision.
If your provider organization recently denied your internal appeal, you may request an external review of that decision.
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).
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.