Chapter 35.1: Health Carrier Internal Appeal Process and External Review

This chapter is comprised of the following sections:

§38.2-3556 Definitions
§38.2-3557 Scope of chapter
§38.2-3558 Health carrier&#8217;s internal appeal process
§38.2-3559 Notice of right to external review
§38.2-3560 Exhaustion of internal appeal process
§38.2-3561 Standard external review
§38.2-3562 Expedited external review
§38.2-3563 External review of experimental or investigational treatment adverse determinations
§38.2-3564 Binding nature of external review decision
§38.2-3565 Minimum qualifications for independent review organizations
§38.2-3566 Approval of independent review organizations
§38.2-3567 Independent review organizations to be held harmless
§38.2-3568 External review reporting requirements
§38.2-3569 Funding of external review
§38.2-3570 Disclosure requirements
§38.2-3571 Regulations
