33-32-415. Binding nature of external review decisions. (1) An external review decision is binding on:
(a) the health insurance issuer; and
(b) the covered person except to the extent that the covered person has other remedies available under applicable federal or state law.
(2) A covered person or, if applicable, the covered person's authorized representative may not file a subsequent request for external review involving the same adverse determination or final adverse determination for which the covered person has already received an external review decision pursuant to this part.
History: En. Sec. 25, Ch. 428, L. 2015.
Structure Montana Code Annotated
Title 33. Insurance and Insurance Companies
Chapter 32. Health Utilization Review
33-32-402. Definitions for external review
33-32-403. Notice of right to external review
33-32-404. Request for external review
33-32-405. Exhaustion of internal grievance process
33-32-406. through 33-32-409 reserved
33-32-410. Standard external review
33-32-411. Expedited external review
33-32-413. and 33-32-414 reserved
33-32-415. Binding nature of external review decisions
33-32-416. Approval of independent review organizations -- renewal
33-32-417. Minimum qualifications for independent review organizations
33-32-418. Liability limits for independent review organization
33-32-421. External review reporting requirements