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
08/25/2023
Utah
Section 31A-22-650
Health care preauthorization requirements
ERISA-Med. Nec. Decisions-Deadlines, Retroactive Denial, 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
Ama Policy
12/30/2021
ERISA-Med. Nec. Decisions-Deadlines, Med. Adv.-Med. Nec. Decisions-Deadlines, State Medical Necessity Decisions-Deadlines
Ama Policy
10/14/2019
ERISA-Med. Nec. Decisions-Deadlines, Med. Adv.-Med. Nec. Appeals-Deadlines, Step Therapy Override
Federal Law
08/30/2023
29 CFR 2560.503-1
ERISA-Med. Nec. Appeals-Deadlines, ERISA-Med. Nec. Decisions-Deadlines, Preemption-ERISA
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
45 CFR 147.136
Internal claims and appeals and external review processes
ERISA-Med. Nec. Appeals-Deadlines, ERISA-Med. Nec. Decisions-Deadlines
State Law
08/26/2023
Vermont
Reg. H-2009-03
Consumer protection and quality requirements for managed care organizations
Amendments, Anti-gag clause, Anti-retaliation, Continuity of Care Post-Contract, Credentialing-Due Process-Denial of Contract, Credentialing-Patient Demographics, Directories, ERISA-Med. Nec. Decisions-Deadlines, Liability-insurer shifting to physician, Medical Necessity-Definition, Network Adequacy, OON-Payment Issues, Prohibited financial incentives, Retroactive Denial, State Medical Necessity Appeals-Deadlines, Termination, Termination-Due Process, U.R. Criteria
State Law
08/26/2023
Washington
Section 284-43-2000
Health care services utilization review-Generally
Anti-retaliation, ERISA-Med. Nec. Decisions-Deadlines, Retroactive Denial, State Medical Necessity Decisions-Deadlines, U.R. Criteria