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<law><site_title>Virginia Decoded</site_title><site_url>https://vacode.org</site_url><law_id>57196</law_id><section_number>32.1-137.15</section_number><catch_line>Adverse determination; appeal</catch_line><edition url="https://vacode.org/2025/" slug="2025" current="TRUE" last_updated="">2025</edition><referred_to_by><reference>32.1-137.10</reference><reference>32.1-137.13</reference><reference>32.1-137.14</reference></referred_to_by><structure><unit label="title" level="1" order_by="1" identifier="32.1">Health</unit><unit label="chapter" level="2" order_by="1" identifier="5">Regulation of Medical Care Facilities and Services</unit><unit label="article" level="3" order_by="1" identifier="1.2">Utilization Review Standards and Appeals</unit></structure><text>
						<section><p>Each <span class="dictionary">entity</span> shall establish an internal <span class="dictionary">appeals</span> process, including a process for urgent care <span class="dictionary">appeals</span>, to consider any <span class="dictionary">adverse determination</span> that is appealed by a <span class="dictionary">covered person</span>, his representative, or his <span class="dictionary">provider</span> in accordance with the provisions of &#xA7;&#xA0;<a class="law" title="Health carrier's internal appeal process" href="/38.2-3558/">38.2-3558</a>.</p></section></text><history>1998, c. 891; 1999, cc. 643, 649, 857; 2000, c. 922; 2010, c. 395; 2011, c. 788.</history><metadata></metadata></law>
