Code of Virginia - Title 38.2 Insurance - Chapter 59 Independent External Review Of Adverse Utilization Review Decisions

• 38.2-5900 Definitions
  As used in this chapter: "Covered person" means an individual, whether a policyholder, subscriber, enrollee, covered dependent, or member of a managed care health insurance ...
• 38.2-5901 Review by the Bureau of Insurance
  A. A covered person or a treating health care provider, with the consent of the covered person, may appeal to the Bureau of Insurance for ...
• 38.2-5902 Appeals; impartial health entity
  A. The Bureau of Insurance shall contract with one or more impartial health entities for the purpose of performing the review of final adverse decisions. ...
• 38.2-5903 Assessment to fund appeals
  A. Each licensed insurer writing insurance as defined in § 38.2-109 and that is subject to subsection B of § 38.2-5801, each health maintenance organization ...
• 38.2-5904 Office of the Managed Care Ombudsman established; responsibilities
  A. The Commission shall create within the Bureau of Insurance the Office of the Managed Care Ombudsman. The Office of the Managed Care Ombudsman shall ...
• 38.2-5905 Regulations
  The Commission shall promulgate regulations effectuating the purpose of this chapter. Such regulations shall include (i) provisions for expedited consideration of appeals in cases involving ...

Last modified: April 3, 2009