514J.101 Purpose — applicability.
The purpose of this chapter is to provide uniform standards for the establishment and maintenance of external review procedures to assure that covered persons have the opportunity for an independent review of an adverse determination or final adverse determination made by a health carrier as required by the federal Patient Protection and Affordable Care Act, Pub. L. No. 111-148, as amended by the federal Health Care and Education Reconciliation Act of 2010, Pub. L. No. 111-152, which amends the Public Health Service Act and adopts, in part, new 42 U.S.C. §300gg-19, and to address issues which are unique to the external review process in this state.
2011 Acts, ch 101, §1
Structure Iowa Code
Chapter 514J - EXTERNAL REVIEW OF HEALTH CARE COVERAGE DECISIONS
Section 514J.1 - Legislative intent.
Section 514J.4 - External review request — fee.
Section 514J.5 - Certification of request — eligibility.
Section 514J.6 - Independent review entities.
Section 514J.7 - External review.
Section 514J.8 - Expedited review.
Section 514J.12 - Standard of review.
Section 514J.13 - Effect of external review decision.
Section 514J.101 - Purpose — applicability.
Section 514J.102 - Definitions.
Section 514J.103 - Applicability and scope.
Section 514J.104 - Notice of right to external review.
Section 514J.105 - Request for external review.
Section 514J.107 - External review — standard.
Section 514J.108 - External review — expedited.
Section 514J.110 - Effect of external review decision.
Section 514J.111 - Approval of independent review organizations.
Section 514J.112 - Minimum qualifications for independent review organizations.
Section 514J.113 - Immunity for independent review organizations.
Section 514J.114 - External review reporting requirements.
Section 514J.115 - Expenses of external review.
Section 514J.116 - Disclosure requirements.
Section 514J.117 - Rulemaking authority.