28 Pa. Code §9.705(c)(1)(vi)
October 15, 2021 5:43 am(vi) The plan shall notify the enrollee in writing of the decision of the initial review committee within 5 business... View more
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28 Pa. Code §9.705(c)(3)(i)
October 15, 2021 5:45 am(i) Both the initial and second level grievance review shall include a licensed physician or an approved licensed psychologist, in... View more
28 Pa. Code §9.753(b)
October 15, 2021 5:46 am(b) A prospective UR decision shall be communicated to the plan, enrollee and health care provider within 2-business days of... View more
28 TAC §19.1718(d)(3)
August 8, 2021 2:17 am(d) An HMO or preferred provider benefit plan must issue and transmit a determination indicating whether the proposed medical or... View more
29 CFR §2560.503-1 (g)(1)
May 5, 2020 9:23 am(g) Manner and content of notification of benefit determination. (1) Except as provided in paragraph (g)(2) of this section, the... View more
29 CFR §2560.503-1(f)(2)(iii)(A)
April 29, 2020 5:43 am(A) Pre-service claims. In the case of a pre-service claim, the plan administrator shall notify the claimant of the plan’s... View more
29 CFR §2560.503-1(f)(2)(iii)(B)
May 23, 2020 5:43 pm(B) Post-service claims. In the case of a post-service claim, the plan administrator shall notify the claimant, in accordance with... View more
29 CFR §2590.711(a) (1-2)
April 29, 2020 5:49 am(a) Hospital length of stay – (1) General rule. Except as provided in paragraph (a)(5) of this section, a group... View more
29 CFR §2590.715-2719(A)(b)(1-2)
May 23, 2020 4:48 pm(1) If a group health plan, or a health insurance issuer offering group health insurance coverage, provides any benefits with... View more
30 U.S.C § 3902(a-c)
May 23, 2020 6:33 pm(a) Under regulations prescribed under section 3903 of this title, the head of an agency acquiring property or service from... View more