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432E-1 Definitions. - Note Sections 432E-1 through 432E-2 designated as Part I by...
432E-1.4 Medical necessity. - §432E-1.4 Medical necessity. (a) For contractual purposes, a health intervention...
432E-1.5 Licensure of managed care plan medical directors. - §432E-1.5 Licensure of managed care plan medical directors. The medical...
432E-2 Conflict with other laws. - §432E-2 Conflict with other laws. If there is a conflict...
432E-3 REPEALED. - Note Sections 432E-3 through 432E-8 designated as Part II by...
432E-4 Enrollee participation in treatment decisions. - §432E-4 Enrollee participation in treatment decisions. (a) An enrollee shall...
432E-5 Complaints and appeals procedure for enrollees. - §432E-5 Complaints and appeals procedure for enrollees. (a) A health...
432E-6 REPEALED. - §432E-6 REPEALED. L 2011, c 230, §10.
432E-6.5 Expedited internal appeal, when authorized; standard for decision. - §432E-6.5 Expedited internal appeal, when authorized; standard for decision. (a)...
432E-7 Information to enrollees. - §432E-7 Information to enrollees. (a) The managed care plan shall...
432E-8 Enforcement. - §432E-8 Enforcement. All remedies, penalties, and proceedings in articles 2...
432E-9 Utilization review. - Note Sections 432E-9 through 432E-13 designated as Part III by...
432E-10 Managed care plan performance measurement and data reporting standards. - §432E-10 Managed care plan performance measurement and data reporting standards....
432E-11 Accreditation of managed care plans. - §432E-11 Accreditation of managed care plans. (a) Beginning January 1,...
432E-12 Rules. - §432E-12 Rules. The commissioner shall adopt rules pursuant to chapter...
432E-13 Annual report. - §432E-13 Annual report. The commissioner shall submit annually to the...
432E-31 Applicability and scope. - Note The amendments made to this chapter by L 2011,...
432E-32 Notice of right to external review. - §432E-32 Notice of right to external review. Notice of the...
432E-33 Request for external review. - §432E-33 Request for external review. (a) All requests for external...
432E-34 Standard external review. - §432E-34 Standard external review. (a) An enrollee or the enrollee's...
432E-35 Expedited external review. - §432E-35 Expedited external review. (a) Except as provided in subsection...
432E-36 External review of experimental or investigational treatment adverse determinations. - §432E-36 External review of experimental or investigational treatment adverse determinations....
432E-37 Binding nature of external review decision. - §432E-37 Binding nature of external review decision. (a) An external...
432E-38 Approval of independent review organizations. - §432E-38 Approval of independent review organizations. (a) An independent review...
432E-39 Minimum qualifications for independent review organizations. - §432E-39 Minimum qualifications for independent review organizations. (a) To be...
432E-40 Hold harmless for independent review organizations. - §432E-40 Hold harmless for independent review organizations. No independent review...
432E-41 External review reporting requirements. - §432E-41 External review reporting requirements. (a) An independent review organization...
432E-42 Funding of external review. - §432E-42 Funding of external review. The health carrier against which...
432E-43 Disclosure requirements. - §432E-43 Disclosure requirements. (a) Each health carrier shall include a...
432E-44 Rules. - §432E-44 Rules. The insurance commissioner shall adopt rules pursuant to...