{"formats":[{"name":"JSON","format":"json","url":"\/downloads\/2025\/code-json\/32.1-138.9.json"},{"name":"Plain Text","format":"text","url":"\/downloads\/2025\/code-text\/32.1-138.9.txt"},{"name":"XML","format":"xml","url":"\/downloads\/2025\/code-xml\/32.1-138.9.xml"},{"name":"HTML","format":"html","url":"\/downloads\/2025\/code-html\/32.1-138.9.html"}],"law_id":56657,"edition_id":1,"section_id":56657,"structure_id":13616,"section_number":"32.1-138.9","catch_line":"Standards for approval","history":"1990, c. 826, \u00a7 38.2-5302; 1998, c. 129.","full_text":"Each private review agent shall file an application with the Department which shall meet the following minimum standards and any additional standards established by regulation pursuant to \u00a7 32.1-138.15, and pay a filing fee established by the Department, in order to be approved by the Department:\n\n1\n\nA description of the procedures to be used in evaluating proposed or delivered hospital, medical, or other health care services;2\n\nThe procedures by which patients or providers may seek reconsideration of determinations by private review agents;3\n\nThe type and qualifications of the personnel either employed or under contract to perform the utilization review;4\n\nProcedures and policies which ensure that patient-specific medical records and information shall be kept strictly confidential except as authorized by the patient or by regulations adopted pursuant to this article; and5\n\nAssurances that reviewers be readily accessible by telephone to patients and providers at least forty hours per week during normal business hours.","order_by":null,"text":{"0":{"id":207301,"text":"Each private review agent shall file an application with the Department which shall meet the following minimum standards and any additional standards established by regulation pursuant to \u00a7 32.1-138.15, and pay a filing fee established by the Department, in order to be approved by the Department:","type":"section","prefixes":[""],"prefix":"","entire_prefix":"","prefix_anchor":"","level":1,"next_prefix":"1"},"1":{"id":207302,"text":"A description of the procedures to be used in evaluating proposed or delivered hospital, medical, or other health care services;","type":"section","prefixes":["1"],"prefix":"1","entire_prefix":"1","prefix_anchor":"1","level":1,"prior_prefix":"","next_prefix":"2"},"2":{"id":207303,"text":"The procedures by which patients or providers may seek reconsideration of determinations by private review agents;","type":"section","prefixes":["2"],"prefix":"2","entire_prefix":"2","prefix_anchor":"2","level":1,"prior_prefix":"1","next_prefix":"3"},"3":{"id":207304,"text":"The type and qualifications of the personnel either employed or under contract to perform the utilization review;","type":"section","prefixes":["3"],"prefix":"3","entire_prefix":"3","prefix_anchor":"3","level":1,"prior_prefix":"2","next_prefix":"4"},"4":{"id":207305,"text":"Procedures and policies which ensure that patient-specific medical records and information shall be kept strictly confidential except as authorized by the patient or by regulations adopted pursuant to this article; 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renewal","url":"\/32.1-138.10\/","token":"32.1\/5\/2.1\/32.1-138.10","metadata":false},{"id":69661,"structure_id":13616,"section_number":"32.1-138.11","catch_line":"Denial; revocation","url":"\/32.1-138.11\/","token":"32.1\/5\/2.1\/32.1-138.11","metadata":false},{"id":54583,"structure_id":13616,"section_number":"32.1-138.12","catch_line":"Waiver of requirements of article","url":"\/32.1-138.12\/","token":"32.1\/5\/2.1\/32.1-138.12","metadata":false},{"id":73931,"structure_id":13616,"section_number":"32.1-138.13","catch_line":"Access to and confidentiality of patient-specific medical records and information","url":"\/32.1-138.13\/","token":"32.1\/5\/2.1\/32.1-138.13","metadata":false},{"id":63195,"structure_id":13616,"section_number":"32.1-138.14","catch_line":"No private right of action created","url":"\/32.1-138.14\/","token":"32.1\/5\/2.1\/32.1-138.14","metadata":false},{"id":66986,"structure_id":13616,"section_number":"32.1-138.15","catch_line":"Regulations","url":"\/32.1-138.15\/","token":"32.1\/5\/2.1\/32.1-138.15","metadata":false},{"id":63369,"structure_id":13616,"section_number":"32.1-138.6","catch_line":"Definitions","url":"\/32.1-138.6\/","token":"32.1\/5\/2.1\/32.1-138.6","metadata":false},{"id":75335,"structure_id":13616,"section_number":"32.1-138.7","catch_line":"Certificates of registration required; issuance; transferability; regulations","url":"\/32.1-138.7\/","token":"32.1\/5\/2.1\/32.1-138.7","metadata":false},{"id":67769,"structure_id":13616,"section_number":"32.1-138.8","catch_line":"Consultation with health regulatory boards","url":"\/32.1-138.8\/","token":"32.1\/5\/2.1\/32.1-138.8","metadata":false},{"id":56657,"structure_id":13616,"section_number":"32.1-138.9","catch_line":"Standards for approval","url":"\/32.1-138.9\/","token":"32.1\/5\/2.1\/32.1-138.9","metadata":false}],"previous_section":{"id":67769,"structure_id":13616,"section_number":"32.1-138.8","catch_line":"Consultation with health regulatory boards","url":"\/32.1-138.8\/","token":"32.1\/5\/2.1\/32.1-138.8","metadata":false},"metadata":false,"official_url":"https:\/\/law.lis.virginia.gov\/vacode\/32.1-138.9\/","history_text":"

This law was first created in 1990. The record of its establishment is cataloged in chapter 826 of that year\u2019s edition of \u201cActs of Assembly,\u201d the annual state publication listing all changes made to the Code of Virginia in that year. Unfortunately, the 1990 \u201cActs\u201d aren\u2019t available online. It has been modified 1 time. Those modifications are cataloged by \u201cThe Acts of Assembly,\u201d a state publication, by year and chapter. Those modifications that can be read on the General Assembly\u2019s website will be linked accordingly. That modification is as follows: in 1998, chapter 129<\/a>.<\/p>","references":false,"refers_to":[{"id":66986,"section_number":"32.1-138.15","catch_line":"Regulations","order_by":null,"url":"\/32.1-138.15\/"}],"permalink":{"id":203235,"object_type":"law","relational_id":56657,"identifier":"32.1-138.9","token":"32.1\/5\/2.1\/32.1-138.9","url":"\/32.1-138.9\/","edition_id":1,"permalink":0,"preferred":1},"url":"\/32.1-138.9\/","token":"32.1\/5\/2.1\/32.1-138.9","dublin_core":{"Title":"Standards for approval","Type":"Text","Format":"text\/html","Identifier":"\u00a7 32.1-138.9","Relation":"Code of Virginia"},"html":"\n\t\t\t\t\t\t

Each private review agent<\/span> shall file an application with the Department<\/span> which shall meet the following minimum standards and any additional standards established by regulation pursuant to \u00a7 32.1-138.15<\/a>, and pay a filing fee established by the Department<\/span>, in order<\/span> to be approved by the Department<\/span>:<\/p><\/section>\n\t\t\t\t\t\t

1.<\/span> A description of the procedures to be used in evaluating proposed or delivered hospital, medical, or other health care services; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

2.<\/span> The procedures by which patients or providers may seek reconsideration of determinations by private review agents<\/span>; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

3.<\/span> The type and qualifications of the personnel either employed or under contract<\/span> to perform the utilization review<\/span>; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

4.<\/span> Procedures and policies which ensure that patient-specific medical records and information shall be kept strictly confidential except as authorized by the patient or by regulations adopted pursuant to this article; and <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

5.<\/span> Assurances that reviewers be readily accessible by telephone to patients and providers at least forty hours per week during normal business hours. <\/i><\/a><\/p><\/section>","plain_text":" CODE OF VIRGINIA\n\nSTANDARDS FOR APPROVAL (\u00a7 32.1-138.9)\n\nEach private review agent shall file an application with the Department which\nshall meet the following minimum standards and any additional standards\nestablished by regulation pursuant to \u00a7 32.1-138.15, and pay a filing fee\nestablished by the Department, in order to be approved by the Department:\n\n1. A description of the procedures to be used in evaluating proposed or\ndelivered hospital, medical, or other health care services;\n\n2. The procedures by which patients or providers may seek reconsideration of\ndeterminations by private review agents;\n\n3. The type and qualifications of the personnel either employed or under\ncontract to perform the utilization review;\n\n4. Procedures and policies which ensure that patient-specific medical records\nand information shall be kept strictly confidential except as authorized by the\npatient or by regulations adopted pursuant to this article; and\n\n5. Assurances that reviewers be readily accessible by telephone to patients and\nproviders at least forty hours per week during normal business hours.\n\nHISTORY: 1990, c. 826, \u00a7 38.2-5302; 1998, c. 129.","edition":{"id":1,"name":"2025","slug":"2025","date_created":"2026-06-21 22:39:22","date_modified":"2026-06-21 22:39:22","current":1,"order_by":1,"last_import":null}}