Office of Patient Protection
Office of Patient Protection (OPP) safeguards important rights of health insurance consumers. Implementing certain provisions of M.G.L. Chapter 176O, OPP regulates the internal grievance process for consumers who wish to challenge denials of coverage by health plans and regulates and administers the external review process for consumers who seek further review of adverse determinations by health plans based on medical necessity. OPP is also charged with regulating similar internal and external review processes for patients of Risk Bearing Provider Organizations and HPC-certified ACOs. OPP also administers and grants enrollment waivers to eligible individuals who seek to purchase non-group insurance when open enrollment is closed. Additionally, OPP assists consumers with general questions or concerns relating to health insurance. OPP is led by Nancy K. Ryan, Esq., MPH.
About the Director
Nancy K. Ryan is the Director of the Office of Patient Protection (OPP). She has been on staff at the Health Policy Commission since 2015, serving the agency as Associate Counsel before becoming the Director of OPP. As Associate Counsel, Nancy provided legal support to policy teams implementing a diverse set of initiatives, including the accountable care organization certification program and OPP’s consumer appeals and waiver programs. Prior to joining the Health Policy Commission, Nancy was a Staff Attorney at Health Law Advocates, a public interest law firm whose mission is to provide pro bono legal representation to low-income residents. There, she represented clients experiencing difficulty accessing or paying for needed medical services and advocated state policymakers on behalf of health care consumers. Nancy received her JD and MPH, as part of a dual-degree program, from Northeastern University School of Law and Tufts University School of Medicine. She is a graduate of the College of the Holy Cross.