California Insurance Code ARTICLE 3.5 - Appeals Seeking Independent Medical Review

• Section 10169.
  (a) Commencing January 1, 2001, there is hereby established in the department the Independent Medical Review System.(b) For the purposes of this chapter, “disputed health care service”...
• Section 10169.1.
  (a) If there is an imminent and serious threat to the health of the insured, as specified in subdivision (c) of Section 10169.3, all necessary information...
• Section 10169.2.
  (a)  The department shall contract with one or more independent medical review organizations in the state to conduct reviews for purposes of this article. The...
• Section 10169.3.
  (a) Upon receipt of information and documents related to a case, the medical professional reviewer or reviewers selected to conduct the review by the independent medical...
• Section 10169.5.
  (a) After considering the results of a competitive bidding process and any other relevant information on program costs, the commissioner shall establish a reasonable, per-case reimbursement...

Last modified: October 22, 2018