Search Results
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
Ama Policy
10/15/2019
State Medical Necessity Appeals-Deadlines
Ama Policy
10/15/2019
State Medical Necessity Appeals-Deadlines
State Law
07/27/2023
Alabama
Section 27-3A-5
Standards for utilization review agents
State Medical Necessity Appeals-Deadlines, State Medical Necessity Decisions-Deadlines
State Law
07/27/2023
Alaska
Section 28.936
Reviews of grievances involving an adverse determination
State Medical Necessity Appeals-Deadlines
State Law
07/27/2023
Alaska
Section 28.938
Expedited reviews of grievances involving an adverse determination
State Medical Necessity Appeals-Deadlines
State Law
01/14/2025
Arizona
Sections 20-2501, 20-2532, 20-2533, 20-2534, 20-2535 and 20-2536
Definitions, scope; Utilization review standards and criteria, requirements; Denial, levels of review, disclosure, additional time after service by mail, review process; Expedited medical review, expedited appeal; Initial appeal; Voluntary internal appeal
State Medical Necessity Appeals-Deadlines, U.R. Criteria
State Law
07/29/2023
Colorado
Regulation 4-2-17
Prompt investigation of health claims involving utilization review and denial of benefits and rules related to internal claims and appeals processes
State Medical Necessity Appeals-Deadlines, State Medical Necessity Decisions-Deadlines
State Law
07/29/2023
Connecticut
Section 38a-591e
Internal grievance process of adverse determinations based on medical necessity. Expedited review of adverse determinations of urgent care requests.
State Medical Necessity Appeals-Deadlines
State Law
08/01/2023
Florida
Section 641.51
Quality assurance program; second medical opinion requirement.
Amendments, Continuity of Care Post-Contract, State Medical Necessity Appeals-Deadlines
