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§ 38.2-3558 Health carrier’s internal appeal process

Each health carrier shall establish an internal appeal process, including a process for urgent care appeals, to consider a utilization review adverse determination or other adverse benefit determination or decision that is appealed by a covered person, his authorized representative, or his provider. The Commission shall promulgate regulations effectuating the purpose of this section, including timeframes for filing appeals, types of claims that may be appealed including rescissions, notice requirements, rights of the covered person, and reviewer requirements.

History

This law was first created in 2011. The record of its establishment is cataloged in chapter 788 of that year’s edition of “Acts of Assembly,” the annual state publication listing all changes made to the Code of Virginia in that year.

2011, c. 788.

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