Each entity shall establish an internal appeals process, including a process for urgent care appeals, to consider any adverse determination that is appealed by a covered person, his representative, or his provider in accordance with the provisions of § 38.2-3558.
1998, c. 891; 1999, cc. 643, 649, 857; 2000, c. 922; 2010, c. 395; 2011, c. 788.
Structure Code of Virginia
Chapter 5 - Regulation of Medical Care Facilities and Services
§ 32.1-125.01. Failing to report; penalty
§ 32.1-125.1. Inspection of hospitals by state agencies generally
§ 32.1-125.2. Disclosure of other providers of services
§ 32.1-125.4. Retaliation or discrimination against complainants
§ 32.1-125.5. Confidentiality of complainant's identity
§ 32.1-126.02. Hospital pharmacy employees; criminal records check required
§ 32.1-126.1. Asbestos inspection for hospitals
§ 32.1-126.2. Fire suppression systems required in nursing facilities and nursing homes
§ 32.1-126.3. Fire suppression systems required in hospitals
§ 32.1-126.4. Hospital standing orders or protocols for certain vaccinations
§ 32.1-126.5. Consolidation of inspections
§ 32.1-127.01. Regulations to authorize certain sanctions and guidelines
§ 32.1-127.1. Immunity from liability for routine referral for organ and tissue donation
§ 32.1-127.1:01. Record storage
§ 32.1-127.1:03. Health records privacy
§ 32.1-127.1:04. Use or disclosure of certain protected health information required
§ 32.1-127.1:05. Breach of medical information notification
§ 32.1-127.3. Immunity from liability for certain free health care services
§ 32.1-128. Applicability to hospitals and nursing homes for practice of religious tenets
§ 32.1-129. Application for license
§ 32.1-131. Expiration and renewal of licenses
§ 32.1-133. Display of license
§ 32.1-133.1. Human trafficking hotline; posted notice required; civil penalty
§ 32.1-134. Family planning information in hospitals providing maternity care
§ 32.1-134.01. Certain information required for maternity patients
§ 32.1-134.02. Infants; blood sample provided to parents
§ 32.1-134.2. Clinical privileges for certain practitioners
§ 32.1-134.3. Response to applications for clinical privileges
§ 32.1-134.4. Right of podiatrists or nurse practitioners to injunction
§ 32.1-135.1. Certain advertisements prohibited
§ 32.1-135.2. Offer or payment of remuneration in exchange for referral prohibited
§ 32.1-136. Violation; penalties
§ 32.1-137. Certification of medical care facilities under Title XVIII of Social Security Act
§ 32.1-137.01. Posting of charity care policies
§ 32.1-137.02. Hospital discharge procedures
§ 32.1-137.03. Discharge planning; designation of individual to provide care
§ 32.1-137.04. Patient notice of observation or outpatient status
§ 32.1-137.06. Lyme disease test result information
§ 32.1-137.07. Violations of certain provisions; penalty
§ 32.1-137.08. Medical care facilities; persons with disabilities; designated support persons
§ 32.1-137.09. Hospital emergency department CPT code data reporting
§ 32.1-137.010. Financial assistance; payment plans
§ 32.1-137.2. Certification of quality assurance; application; issuance; denial; renewal
§ 32.1-137.4. Examination, review or investigation
§ 32.1-137.6. Complaint system
§ 32.1-137.8. Application to and compliance by utilization review entities
§ 32.1-137.9. Requirements and standards for utilization review entities
§ 32.1-137.10. Utilization review plan required
§ 32.1-137.11. Accessibility of utilization review entity
§ 32.1-137.13. Adverse determination
§ 32.1-137.14. Reconsideration of adverse determination
§ 32.1-137.15. Adverse determination; appeal
§ 32.1-137.17. Limitation on Commissioner's jurisdiction
§ 32.1-138.1. Implementation of transfer and discharge policies
§ 32.1-138.2. Certain contract provisions prohibited
§ 32.1-138.3. Third party guarantor prohibition
§ 32.1-138.4. Retaliation or discrimination against complainants
§ 32.1-138.5. Confidentiality of complainant's identity
§ 32.1-138.7. Certificates of registration required; issuance; transferability; regulations
§ 32.1-138.8. Consultation with health regulatory boards
§ 32.1-138.9. Standards for approval
§ 32.1-138.10. Expiration; renewal
§ 32.1-138.11. Denial; revocation
§ 32.1-138.12. Waiver of requirements of article
§ 32.1-138.13. Access to and confidentiality of patient-specific medical records and information
§ 32.1-138.14. No private right of action created
§ 32.1-162.2. Exemptions from article
§ 32.1-162.3. License required for hospice programs; notice of denial of license; renewal thereof
§ 32.1-162.5:1. Notice to dispenser of patient's death; disposition of dispensed drugs
§ 32.1-162.6. Revocation or suspension of license
§ 32.1-162.6:1. Possession or administration of cannabis oil
§ 32.1-162.8. Exemptions from article
§ 32.1-162.9. Licenses required; renewal thereof
§ 32.1-162.10. Inspections; fees
§ 32.1-162.11. Liability insurance required
§ 32.1-162.13. Revocation or suspension of license
§ 32.1-162.15. Violation; penalties
§ 32.1-162.15:1. Unlawful advertising as a home care organization
§ 32.1-162.15:2. (Effective July 1, 2023) Definitions
§ 32.1-162.15:3. (Effective July 1, 2023) Services for survivors of sexual assault; plan required
§ 32.1-162.15:4. (For effective date, see Acts 2020, c 725) Treatment services
§ 32.1-162.15:5. Transfer services
§ 32.1-162.15:7. (Effective July 1, 2023) Inspections; report required
§ 32.1-162.15:9. (Effective July 1, 2023) Submission of evidence
§ 32.1-162.15:10. (Effective July 1, 2023) Complaints
§ 32.1-162.15:11. Task Force on Services for Survivors of Sexual Assault