NY Ins L §4903(a)(2-3)

August 8, 2021 3:10 pm Published by

(a) Utilization review shall be conducted by:

(2) A health care professional who is appropriately trained in the principles, procedures and standards of such utilization review agent;  provided, however, that a health care professional who is not a clinical peer reviewer may not render an adverse determination;

(3) A clinical peer reviewer where the review involves an adverse determination.

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