State Law

Utah Admin Code-Title R590-Rule R590-203. Health Grievance Review Process

08/26/2022 Utah Section R590-203-5

Adverse Benefit Determination

ERISA-Med. Nec. Appeals-Deadlines, State Medical Necessity Appeals-Deadlines

(1) An adverse benefit determination review procedure shall comply with the adverse benefit determination review requirements set forth in 29 CFR 2560.503-1.

(2) A carrier’s adverse benefit determination appeal board or body shall include at least one consumer representative who is present at every meeting.