                                 CODE OF VIRGINIA

APPROVAL OF INDEPENDENT REVIEW ORGANIZATIONS (§ 38.2-3566)

A. Each independent review organization that wishes to be eligible to conduct
external reviews shall submit an application to the Commission for approval or
reapproval. The Commission may charge a reasonable fee for initial approval and
each reapproval.

B. The Commission shall approve independent review organizations that meet the
minimum qualifications to conduct external reviews. Such approval is not subject
to the Virginia Public Procurement Act (&#xA7; 2.2-4300 et seq.).

C. An independent review organization is eligible for approval if it is
accredited by a nationally recognized private accrediting entity that the
Commission has determined has standards that are equivalent to or at least meet
the minimum qualifications for independent review organizations.

D. An approval or reapproval is effective for two years, unless the Commission
determines before its expiration that the independent review organization is not
satisfying the minimum qualifications or its decisions have been consistently
unclear or incomplete. Whenever the Commission determines that an independent
review organization has lost its accreditation or does not meet the requirements
of this subsection, the Commission shall terminate the approval of the
independent review organization and remove it from the list of independent
review organizations approved to conduct external reviews.

E. The Commission shall maintain and periodically update a list of approved
independent review organizations.

F. The assignment by the Commission of an approved independent review
organization shall be done on a random basis, taking into consideration the
nature of the health care service or treatment.

HISTORY: 2011, c. 788.