WAC 284-43-2000 (7)(c)(ii)
January 22, 2025 12:47 am(ii) Whenever there is an adverse determination the issuer must notify the provider or facility and the enrollee. The issuer... View more
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WAC 284-43-2050 (10)(a)(i-ii)
January 22, 2025 12:39 am(10) The time frames for carrier prior authorization determination and notification to a participating provider or facility are as follows:... View more
WAC 284-43-3070 (1-2, 4-8)
January 22, 2025 12:48 am(1) A carrier must notify enrollees of an adverse benefit determination either electronically or by U.S. mail. The notification must... View more
WAC 284-43-3110 (6)
January 22, 2025 12:44 amReview of adverse determinations must be performed by health care providers or staff who were not involved in the initial... View more
Welfare & Institutions Code §14133.9(d)
September 3, 2020 5:13 am(d) When a proposed treatment meets objective medical criteria, and is not contraindicated, authorization for the treatment shall be provided within... View more