NY Ins L §4904(c-d)
August 8, 2021 3:38 am(c) A utilization review agent shall establish a standard appeal process which includes procedures for appeals to be filed in writing... View more
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NY Ins L §4904(c)
August 17, 2021 5:05 pm(c) A utilization review agent shall establish a standard appeal process which includes procedures for appeals to be filed in writing... View more
NY Ins L §4904(d)
August 8, 2021 3:11 pm(d) Both expedited and standard appeals shall only be conducted by clinical peer reviewers, provided that any such appeal shall be... View more
Ohio Rev Code §3901.381(B)(1)
October 15, 2021 5:36 am(B)(1) Unless division (B)(2) or (3) of this section applies, when a third-party payer receives from a provider or beneficiary... View more
Ohio Rev Code §3901.388(A,C)
October 15, 2021 5:36 am(A) A payment made by a third-party payer to a provider in accordance with sections 3901.381 to 3901.386 of the... View more
Ohio Rev Code §3923.041(B)(4)(a)
October 15, 2021 5:36 am(a) For policies issued on or after January 1, 2018, if the health care practitioner submits the request for prior... View more
Ohio Rev Code §3923.65(B)
October 15, 2021 5:39 am(B) Every individual or group policy of sickness and accident insurance that provides hospital, surgical, or medical expense coverage shall... View more
RCW 48.43.041 (1)(a)
January 22, 2025 12:42 am(a) Maternity services that include, with no enrollee cost-sharing requirements beyond those generally applicable cost-sharing requirements: Diagnosis of pregnancy; prenatal... View more
RCW 48.43.093 (1)(a)
January 22, 2025 12:45 am(a) A health carrier shall cover emergency services necessary to screen and stabilize a covered person if a prudent layperson... View more
RCW 48.43.093 (1)(b)
January 22, 2025 12:54 am(b) If an authorized representative of a health carrier authorizes coverage of emergency services, the health carrier shall not subsequently... View more