Requirements for Group Health Plans and Health Insurance Issuers Relating to Internal Claims and Appeals and External Review Processes Under the Patient Protection and Affordable Care Act, 43109-43110 [2010-18050]
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Federal Register / Vol. 75, No. 141 / Friday, July 23, 2010 / Proposed Rules
Dated: July 14, 2010.
Todd A. Stevenson,
Secretary, U.S. Consumer Product Safety
Commission.
CC:PA:LPD:PR (REG–125592–10),
Courier’s Desk, Internal Revenue
Service, 1111 Constitution Avenue,
NW., Washington, DC 20224.
Alternatively, taxpayers may submit
comments electronically via the Federal
eRulemaking Portal at https://
www.regulations.gov (IRS REG–125592–
10).
FOR FURTHER INFORMATION CONTACT:
Concerning the regulations, Karen Levin
at 202–622–6080; concerning
submissions of comments,
Oluwafunmilayo Taylor at 202–622–
7180 (not toll-free numbers).
SUPPLEMENTARY INFORMATION:
[FR Doc. 2010–17591 Filed 7–22–10; 8:45 am]
BILLING CODE 6355–01–P
DEPARTMENT OF THE TREASURY
Internal Revenue Service
26 CFR Part 54
[REG–125592–10]
RIN 1545–BJ62
Requirements for Group Health Plans
and Health Insurance Issuers Relating
to Internal Claims and Appeals and
External Review Processes Under the
Patient Protection and Affordable Care
Act
Internal Revenue Service (IRS),
Treasury.
ACTION: Notice of proposed rulemaking
by cross-reference to temporary
regulations.
AGENCY:
Elsewhere in this issue of the
Federal Register, the IRS is issuing
temporary regulations under the
provisions of the Patient Protection and
Affordable Care Act (the Affordable Care
Act) regarding internal claims and
appeals and external review processes.
The IRS is issuing the temporary
regulations at the same time that the
Employee Benefits Security
Administration of the U.S. Department
of Labor and the Office of Consumer
Information and Insurance Oversight of
the U.S. Department of Health and
Human Services are issuing
substantially similar interim final
regulations with respect to group health
plans and health insurance coverage
offered in connection with a group
health plan under the Employee
Retirement Income Security Act of 1974
and the Public Health Service Act. The
temporary regulations provide guidance
to employers, group health plans, and
health insurance issuers providing
group health insurance coverage. The
text of those temporary regulations also
serves as the text of these proposed
regulations.
WReier-Aviles on DSKGBLS3C1PROD with PROPOSALS
SUMMARY:
Written or electronic comments
and requests for a public hearing must
be received by October 21, 2010.
ADDRESSES: Send submissions to:
CC:PA:LPD:PR (REG–125592–10), Room
5205, Internal Revenue Service, P.O.
Box 7604, Ben Franklin Station,
Washington, DC 20044. Submissions
may be hand-delivered to:
DATES:
VerDate Mar<15>2010
15:12 Jul 22, 2010
Jkt 220001
Background and Explanation of
Provisions
The temporary regulations published
elsewhere in this issue of the Federal
Register add § 54.9815–2719T to the
Miscellaneous Excise Tax Regulations.
The proposed and temporary
regulations are being published as part
of a joint rulemaking with the
Department of Labor and the
Department of Health and Human
Services (the joint rulemaking). The text
of those temporary regulations also
serves as the text of these proposed
regulations. The preamble to the
temporary regulations explains the
temporary regulations and these
proposed regulations.
Special Analyses
It has been determined that this notice
of proposed rulemaking is not a
significant regulatory action as defined
in Executive Order 12866. Therefore, a
regulatory assessment is not required. It
has also been determined that section
553(b) of the Administrative Procedure
Act (5 U.S.C. chapter 5) does not apply
to this proposed regulation. It is hereby
certified that the collections of
information contained in this notice of
proposed rulemaking will not have a
significant impact on a substantial
number of small entities. Accordingly, a
regulatory flexibility analysis under the
Regulatory Flexibility Act (5 U.S.C.
chapter 6) is not required. Section
54.9815–2719T of the temporary
regulations requires both group health
insurance issuers and group health
plans to establish internal claims and
appeals and external review processes
for adverse benefit determinations.
Those processes require the plan and
issuer to disclose evidence relied upon
in making an adverse benefit
determination, to disclose any new
rationale for upholding an adverse
benefit determination as part of an
internal appeal, to provide notice of an
adverse benefit determination and of a
PO 00000
Frm 00018
Fmt 4702
Sfmt 4702
43109
final internal adverse benefit
determination, and to disclose the right
to an external review. Under the
temporary regulations, if a health
insurance issuer satisfies the obligations
to have effective internal claims and
appeals and external review processes
(including these information collection
requirements that are an inherent part of
those processes), those obligations are
satisfied not just for the issuer but also
for the group health plan. For group
health plans maintained by small
entities, it is anticipated that the health
insurance issuer will satisfy those
obligations to have effective internal
claims and appeals and external review
processes (including these information
collection requirements that are an
inherent part of those processes) for
both the plan and the issuer in almost
all cases. For this reason, these
information collection requirements
will not impose a significant impact on
a substantial number of small entities.
Pursuant to section 7805(f) of the
Internal Revenue Code, this regulation
has been submitted to the Chief Counsel
for Advocacy of the Small Business
Administration for comment on its
impact on small business.
Comments and Requests for a Public
Hearing
Before these proposed regulations are
adopted as final regulations,
consideration will be given to any
written comments (a signed original and
eight (8) copies) or electronic comments
that are submitted timely to the IRS.
Comments are specifically requested on
the clarity of the proposed regulations
and how they may be made easier to
understand. All comments will be
available for public inspection and
copying. A public hearing may be
scheduled if requested in writing by a
person that timely submits written
comments. If a public hearing is
scheduled, notice of the date, time, and
place for the hearing will be published
in the Federal Register.
Drafting Information
The principal author of these
proposed regulations is Karen Levin,
Office of the Division Counsel/Associate
Chief Counsel (Tax Exempt and
Government Entities), IRS. The
proposed regulations, as well as the
temporary regulations, have been
developed in coordination with
personnel from the U.S. Department of
Labor and the U.S. Department of
Health and Human Services.
E:\FR\FM\23JYP1.SGM
23JYP1
43110
Federal Register / Vol. 75, No. 141 / Friday, July 23, 2010 / Proposed Rules
List of Subjects in 26 CFR Part 54
Excise taxes, Health care, Health
insurance, Pensions, Reporting and
recordkeeping requirements.
Proposed Amendments to the
Regulations
Accordingly, 26 CFR part 54 is
proposed to be amended as follows:
PART 54—PENSION EXCISE TAXES
Paragraph 1. The authority citation
for part 54 is amended by adding an
entry in numerical order to read in part
as follows:
Authority: 26 U.S.C. 7805 * * *
Section 54.9815–2719 also issued under 26
U.S.C. 9833. * * *
Par. 2. Section 54.9815–2719 is added
to read as follows:
§ 54.9815–2719 Internal claims and
appeals and external review processes.
[The text of proposed § 54.9815–2719
is the same as the text of paragraphs (a)
through (f) of § 54.9815–2719T
published elsewhere in this issue of the
Federal Register].
Steven Miller,
Deputy Commissioner for Services and
Enforcement.
[FR Doc. 2010–18050 Filed 7–22–10; 8:45 am]
BILLING CODE 4830–01–P
Background
DEPARTMENT OF THE TREASURY
Internal Revenue Service
26 CFR Part 300
[REG–139343–08]
RIN 1545–B171
User Fees Relating to Enrollment and
Preparer Tax Identification Numbers
Internal Revenue Service (IRS),
Treasury.
ACTION: Notice of proposed rulemaking
and notice of public hearing.
AGENCY:
This document contains
proposed amendments to the
regulations relating to the imposition of
certain user fees on certain tax
practitioners. The proposed regulations
establish a new user fee for individuals
who apply for or renew a preparer tax
identification number (PTIN). The
proposed regulations affect individuals
who apply for or renew a PTIN. The
charging of user fees is authorized by
the Independent Offices Appropriations
Act of 1952.
DATES: Written or electronic comments
must be received by August 23, 2010.
Outlines of topics to be discussed at the
WReier-Aviles on DSKGBLS3C1PROD with PROPOSALS
SUMMARY:
VerDate Mar<15>2010
15:12 Jul 22, 2010
public hearing scheduled for Tuesday,
August 24, 2010, at 10 a.m. must be
received by Monday, August 23, 2010.
ADDRESSES: Send submissions to:
CC:PA:LPD:PR (REG–139343–08), Room
5205, Internal Revenue Service, P.O.
Box 7604, Ben Franklin Station,
Washington, DC 20044. Submissions
may be hand-delivered Monday through
Friday between the hours of 8 a.m. and
4 p.m. to CC:PA:LPD:PR (REG–139343–
08), Courier’s Desk, Internal Revenue
Service, 1111 Constitution Avenue,
NW., Washington, DC, or sent
electronically via the Federal
eRulemaking Portal at https://
www.regulations.gov (IRS REG–139343–
08). The public hearing will be held in
the Auditorium of the Internal Revenue
Building, 1111 Constitution Avenue,
NW., Washington, DC.
FOR FURTHER INFORMATION CONTACT:
Concerning the proposed regulations,
Emily M. Lesniak at (202) 622–4940;
concerning cost methodology, Eva J.
Williams at (202) 435–5514; concerning
submission of comments, the public
hearing, or to be placed on the building
access list to attend the public hearing,
Richard A. Hurst at
Richard.A.Hurst@irscounsel.treas.gov or
(202) 622–7180 (not toll-free numbers).
SUPPLEMENTARY INFORMATION:
Jkt 220001
Section 330 of title 31 of the United
States Code authorizes the Secretary of
the Treasury to regulate the practice of
representatives before the Treasury
Department. Pursuant to section 330 of
title 31, the Secretary has published
regulations governing practice before
the IRS in 31 CFR part 10 and reprinted
the regulations as Treasury Department
Circular No. 230 (Circular 230). Circular
230 is administered by the IRS Office of
Professional Responsibility (OPR).
User Fee for PTINs
Section 6109 of the Internal Revenue
Code (Code) authorizes the Secretary to
prescribe regulations for the inclusion of
a tax return preparer’s identifying
number on a return, statement, or other
document required to be filed with the
IRS. Section 6109(c) further authorizes
the Secretary ‘‘to require such
information as may be necessary to
assign an identifying number to any
person.’’ As currently prescribed in
regulations, the identifying number of a
tax return preparer who is an individual
is the tax return preparer’s social
security number (SSN) or alternative
number as prescribed by the IRS.
Proposed regulations under section
6109 (REG–134235–08) were published
in the Federal Register (75 FR 14539) on
PO 00000
Frm 00019
Fmt 4702
Sfmt 4702
March 26, 2010, and provide that, for
returns or claims for refund filed after
December 31, 2010, the identifying
number of a tax return preparer is the
individual’s PTIN or such other number
prescribed by the IRS in forms,
instructions, or other appropriate
guidance. The proposed regulations
under section 6109 require a tax return
preparer who prepares all or
substantially all of a return or claim for
refund of tax after December 31, 2010 to
have a PTIN. The proposed regulations
also state that the IRS will provide
through other guidance (including forms
and instructions) guidance regarding
how to apply for a PTIN or other
prescribed preparer identifying number,
for the regular renewal of a PTIN or
other prescribed preparer identifying
number, and for the payment of a user
fee. Only attorneys, certified public
accountants, enrolled agents, and
registered tax return preparers will be
eligible to apply for a PTIN. The
requirements to become a registered tax
return preparer will be provided in
future Circular 230 guidance.
A third party vendor will administer
the PTIN application and renewal
process and will charge a reasonable fee
that is independent of the user fee
charged by the government. The vendor
will develop a web-based database that
individuals will use to apply for or
renew a PTIN and will process paper
PTIN applications. The database also
will be used for applications to become
registered tax return preparers, to renew
the registered tax return preparers’
status, to self-certify continuing
professional education credits for
registered tax return preparers, and to
pay applicable user fees.
Proposed § 300.9 establishes a $50
user fee to apply for or renew a PTIN.
The $50 user fee is based on an annual
PTIN renewal period, and the
procedures for renewing a PTIN will be
provided in other guidance, including
forms and instructions. The user fee is
nonrefundable regardless of whether the
applicant receives a PTIN.
PTINs were previously issued to tax
return preparers solely for the
convenience of the tax return preparers,
providing an alternative to using the tax
return preparers’ social security
numbers. Requiring registration through
the use of PTINs will enable the IRS to
better collect and track data on tax
return preparers. This data will allow
the IRS to track the number of persons
who prepare returns, track the
qualifications of those who prepare
returns, track the number of returns
each person prepares, and more easily
locate and review returns prepared by a
E:\FR\FM\23JYP1.SGM
23JYP1
]]>Agencies
[Federal Register Volume 75, Number 141 (Friday, July 23, 2010)]
[Proposed Rules]
[Pages 43109-43110]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2010-18050]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF THE TREASURY
Internal Revenue Service
26 CFR Part 54
[REG-125592-10]
RIN 1545-BJ62
Requirements for Group Health Plans and Health Insurance Issuers
Relating to Internal Claims and Appeals and External Review Processes
Under the Patient Protection and Affordable Care Act
AGENCY: Internal Revenue Service (IRS), Treasury.
ACTION: Notice of proposed rulemaking by cross-reference to temporary
regulations.
-----------------------------------------------------------------------
SUMMARY: Elsewhere in this issue of the Federal Register, the IRS is
issuing temporary regulations under the provisions of the Patient
Protection and Affordable Care Act (the Affordable Care Act) regarding
internal claims and appeals and external review processes. The IRS is
issuing the temporary regulations at the same time that the Employee
Benefits Security Administration of the U.S. Department of Labor and
the Office of Consumer Information and Insurance Oversight of the U.S.
Department of Health and Human Services are issuing substantially
similar interim final regulations with respect to group health plans
and health insurance coverage offered in connection with a group health
plan under the Employee Retirement Income Security Act of 1974 and the
Public Health Service Act. The temporary regulations provide guidance
to employers, group health plans, and health insurance issuers
providing group health insurance coverage. The text of those temporary
regulations also serves as the text of these proposed regulations.
DATES: Written or electronic comments and requests for a public hearing
must be received by October 21, 2010.
ADDRESSES: Send submissions to: CC:PA:LPD:PR (REG-125592-10), Room
5205, Internal Revenue Service, P.O. Box 7604, Ben Franklin Station,
Washington, DC 20044. Submissions may be hand-delivered to:
CC:PA:LPD:PR (REG-125592-10), Courier's Desk, Internal Revenue Service,
1111 Constitution Avenue, NW., Washington, DC 20224. Alternatively,
taxpayers may submit comments electronically via the Federal
eRulemaking Portal at https://www.regulations.gov (IRS REG-125592-10).
FOR FURTHER INFORMATION CONTACT: Concerning the regulations, Karen
Levin at 202-622-6080; concerning submissions of comments,
Oluwafunmilayo Taylor at 202-622-7180 (not toll-free numbers).
SUPPLEMENTARY INFORMATION:
Background and Explanation of Provisions
The temporary regulations published elsewhere in this issue of the
Federal Register add Sec. 54.9815-2719T to the Miscellaneous Excise
Tax Regulations. The proposed and temporary regulations are being
published as part of a joint rulemaking with the Department of Labor
and the Department of Health and Human Services (the joint rulemaking).
The text of those temporary regulations also serves as the text of
these proposed regulations. The preamble to the temporary regulations
explains the temporary regulations and these proposed regulations.
Special Analyses
It has been determined that this notice of proposed rulemaking is
not a significant regulatory action as defined in Executive Order
12866. Therefore, a regulatory assessment is not required. It has also
been determined that section 553(b) of the Administrative Procedure Act
(5 U.S.C. chapter 5) does not apply to this proposed regulation. It is
hereby certified that the collections of information contained in this
notice of proposed rulemaking will not have a significant impact on a
substantial number of small entities. Accordingly, a regulatory
flexibility analysis under the Regulatory Flexibility Act (5 U.S.C.
chapter 6) is not required. Section 54.9815-2719T of the temporary
regulations requires both group health insurance issuers and group
health plans to establish internal claims and appeals and external
review processes for adverse benefit determinations. Those processes
require the plan and issuer to disclose evidence relied upon in making
an adverse benefit determination, to disclose any new rationale for
upholding an adverse benefit determination as part of an internal
appeal, to provide notice of an adverse benefit determination and of a
final internal adverse benefit determination, and to disclose the right
to an external review. Under the temporary regulations, if a health
insurance issuer satisfies the obligations to have effective internal
claims and appeals and external review processes (including these
information collection requirements that are an inherent part of those
processes), those obligations are satisfied not just for the issuer but
also for the group health plan. For group health plans maintained by
small entities, it is anticipated that the health insurance issuer will
satisfy those obligations to have effective internal claims and appeals
and external review processes (including these information collection
requirements that are an inherent part of those processes) for both the
plan and the issuer in almost all cases. For this reason, these
information collection requirements will not impose a significant
impact on a substantial number of small entities. Pursuant to section
7805(f) of the Internal Revenue Code, this regulation has been
submitted to the Chief Counsel for Advocacy of the Small Business
Administration for comment on its impact on small business.
Comments and Requests for a Public Hearing
Before these proposed regulations are adopted as final regulations,
consideration will be given to any written comments (a signed original
and eight (8) copies) or electronic comments that are submitted timely
to the IRS. Comments are specifically requested on the clarity of the
proposed regulations and how they may be made easier to understand. All
comments will be available for public inspection and copying. A public
hearing may be scheduled if requested in writing by a person that
timely submits written comments. If a public hearing is scheduled,
notice of the date, time, and place for the hearing will be published
in the Federal Register.
Drafting Information
The principal author of these proposed regulations is Karen Levin,
Office of the Division Counsel/Associate Chief Counsel (Tax Exempt and
Government Entities), IRS. The proposed regulations, as well as the
temporary regulations, have been developed in coordination with
personnel from the U.S. Department of Labor and the U.S. Department of
Health and Human Services.
[[Page 43110]]
List of Subjects in 26 CFR Part 54
Excise taxes, Health care, Health insurance, Pensions, Reporting
and recordkeeping requirements.
Proposed Amendments to the Regulations
Accordingly, 26 CFR part 54 is proposed to be amended as follows:
PART 54--PENSION EXCISE TAXES
Paragraph 1. The authority citation for part 54 is amended by
adding an entry in numerical order to read in part as follows:
Authority: 26 U.S.C. 7805 * * *
Section 54.9815-2719 also issued under 26 U.S.C. 9833. * * *
Par. 2. Section 54.9815-2719 is added to read as follows:
Sec. 54.9815-2719 Internal claims and appeals and external review
processes.
[The text of proposed Sec. 54.9815-2719 is the same as the text of
paragraphs (a) through (f) of Sec. 54.9815-2719T published elsewhere
in this issue of the Federal Register].
Steven Miller,
Deputy Commissioner for Services and Enforcement.
[FR Doc. 2010-18050 Filed 7-22-10; 8:45 am]
BILLING CODE 4830-01-P
