RCW 48.43.093 (d)
January 22, 2025 12:56 am(d) If a health carrier requires preauthorization for post evaluation or post stabilization services, the health carrier shall provide access... View more
Archives
RCW 48.43.115 (3)
January 22, 2025 12:43 am(3)(a) Every health carrier that provides coverage for maternity services must permit the attending provider, in consultation with the mother,... View more
RCW 48.43.525 (1)
January 22, 2025 12:54 am(1) A health carrier that offers a health plan shall not retrospectively deny coverage for emergency and nonemergency care that... View more
RCW 48.43.600 (1-3)
January 22, 2025 12:51 am(1) Except in the case of fraud, or as provided in subsections (2) and (3) of this section, a carrier... View more
RI Gen L § 27-18.9-6(a)(1-2)
October 15, 2021 5:26 am(1) For urgent or emergent healthcare services, benefit determinations (adverse or non-adverse) shall be made as soon as possible taking... View more
RI Gen L § 27-18.9-6(a)(3)
October 15, 2021 5:35 am(3) For pre-service claims (adverse or non-adverse), within a reasonable period of time appropriate to the medical circumstances, but not... View more
RI Gen L § 27-18.9-6(b)(2)
October 15, 2021 5:33 am(2) Notification content shall: (i) Be culturally and linguistically appropriate; (ii) Provide details of a claim that is being denied... View more
RI Gen L § 27-18.9-7(b)(3)(iii-iv)
October 15, 2021 5:34 am(iii) When the appeal of any adverse benefit determination, including an appeal of a reconsideration decision, is based in whole... View more
RI Gen L § 27-41-30.1(a)
October 15, 2021 5:34 am(a) Every individual or group hospital or medical services plan contract delivered, issued for delivery, or renewed in this state... View more
RI Gen L § 27-41-64(a)
October 15, 2021 5:26 am(a) A health care entity or health plan operating in the state shall pay all complete claims for covered health... View more