Search Results
Federal Law
08/30/2023
45 CFR 147.136
Internal claims and appeals and external review processes
ERISA-Med. Nec. Appeals-Deadlines, ERISA-Med. Nec. Decisions-Deadlines
Federal Law
08/30/2023
42 USC Section 300gg-19
ERISA-Med. Nec. Appeals-Deadlines, ERISA-Med. Nec. Decisions-Deadlines
Federal Law
08/30/2023
29 CFR 2560.503-1
ERISA-Med. Nec. Appeals-Deadlines, ERISA-Med. Nec. Decisions-Deadlines, Preemption-ERISA
Ama Policy
10/14/2019
ERISA-Med. Nec. Decisions-Deadlines, Med. Adv.-Med. Nec. Appeals-Deadlines, Step Therapy Override
Ama Policy
12/30/2021
ERISA-Med. Nec. Decisions-Deadlines, Med. Adv.-Med. Nec. Decisions-Deadlines, State Medical Necessity Decisions-Deadlines
Ama Policy
08/29/2023
ERISA-Med. Nec. Appeals-Deadlines, ERISA-Med. Nec. Decisions-Deadlines, State Medical Necessity Appeals-Deadlines, State Medical Necessity Decisions-Deadlines, Step Therapy Override, U.R. Criteria
Federal Law
08/30/2023
26 CFR Sections 54.9815-2719 and 54.9815-2719T
Internal claims and appeals and external review processes; Internal claims and appeals and external review processes (temporary)
ERISA-Med. Nec. Appeals-Deadlines, ERISA-Med. Nec. Decisions-Deadlines
State Law
08/05/2023
Kentucky
Section 304.17A-607
Duties of insurer or private review agent performing utilization reviews — Requirement for registration — Consequences of insurer’s failure to make timely utilization review determination — Requirement that insurer or private review agent submit changes to the department — Requirement that private review agent provide timely notice of entities for whom it is providing review.
ERISA-Med. Nec. Decisions-Deadlines, State Medical Necessity Decisions-Deadlines
State Law
08/15/2023
North Dakota
Section 26.1-36-47
Internal claims and appeals procedures
ERISA-Med. Nec. Appeals-Deadlines, ERISA-Med. Nec. Decisions-Deadlines, State Medical Necessity Appeals-Deadlines, State Medical Necessity Decisions-Deadlines
State Law
08/15/2023
North Dakota
Section 26.1-26.4-04
Minimum standards of utilization review agents
ERISA-Med. Nec. Appeals-Deadlines, ERISA-Med. Nec. Decisions-Deadlines, State Medical Necessity Appeals-Deadlines, State Medical Necessity Decisions-Deadlines
