Search Results
Ama Policy
03/13/2019
Credentialing-Due Process-Denial of Contract, Profiling, U.R. Criteria
Ama Policy
03/13/2019
Credentialing-Due Process-Denial of Contract, Termination, Termination-Due Process
Ama Policy
03/13/2019
Credentialing-Due Process-Denial of Contract, Termination-Due Process
Ama Policy
10/15/2019
Credentialing-Due Process-Denial of Contract
Ama Policy
10/15/2019
Credentialing-Due Process-Denial of Contract
State Law
07/11/2023
Arkansas
Section 23-99-1120 (Gold Card Law)
Initial exemption from prior authorization requirements for healthcare providers providing certain healthcare services; Duration of prior authorization exemption; Denial or rescission of prior authorization exemption; Independent review of exemption determination; Effect of appeal of independent review organization determination; Eligibility for prior authorization exemption following
finalized exemption rescission or denial; Effect of prior authorization exemption; Applicability; Prescription drugs, medicines, biological products, pharmaceuticals, or pharmaceutical services; Appeals process for disallowance of prior authorization
Credentialing-Due Process-Denial of Contract
State Law
01/21/2025
Maine
Section 4303
Amendments, Anti-gag clause, Anti-retaliation, Continuity of Care Post-Contract, Credentialing-Deadlines, Credentialing-Due Process-Denial of Contract, Credentialing-Payment Issues, Fee Schedules, Most Favored Nation, Overpayments / Recoupments, Participation in Products, Plans, or Networks, Prohibited financial incentives, Retroactive Denial, Termination, Termination-Due Process
State Law
08/07/2023
Maine
Sections 1-10
Purpose; Authority; Applicability and Scope; Affordable Care Act; Definitions; Quality Assurance Standards; Access to Services; Adverse Health Care Treatment Decisions; Grievance Register and Grievance Procedures; Reporting Requirements; Effective Date
Credentialing-Deadlines, Credentialing-Due Process-Denial of Contract, Network Adequacy, Retroactive Denial, State Medical Necessity Appeals-Deadlines, State Medical Necessity Decisions-Deadlines, U.R. Criteria
State Law
03/20/2021
Michigan
Section 500.3531
Contracts with health care providers to become affiliated providers; requirements; standards; filing; duplicative standards; notice procedures; provider application period; approval or rejection as affiliated provider; termination of contract; providing information to insurer.
Credentialing-Due Process-Denial of Contract
State Law
08/10/2023
Nebraska
Section 44-4109.01
Policies or contracts; requirements
Credentialing-Due Process-Denial of Contract, Credentialing-Patient Demographics, Termination-Due Process
