§ 65.2-1306. Corrective action
A. If it is determined that a physician improperly overutilized or otherwise rendered or ordered inappropriate medical treatment or services, or that the cost or duration of such treatment or services was inappropriate, the regional peer review committee shall, in accordance with the standard set forth in § 65.2-605, adjust the amount of reimbursement to which the physician is entitled pursuant to this title and, if the physician already has been paid, shall require such physician to repay any excess amount that was paid to him for rendering or ordering such treatment or services.
B. Any such determination by any regional peer review committee shall be reviewable by the Commission, which shall have exclusive jurisdiction to effect any such review. Any review by the Commission shall be pursuant to § 65.2-714. To be entitled to review by the Commission, the physician must deliver to the Commission written notice of his request for review, which notice must be received within thirty days after notice of the decision of the regional peer review committee is received by the physician.
C. By accepting payment pursuant to this title, (i) any physician, any hospital and any employee shall be deemed to have consented to the submitting of all records concerning treatment of the employee to the Commission, to the Statewide Coordinating Committee, to any regional peer review committee, or to any agent of any such committee and (ii) any physician shall be deemed to agree to comply with any decision of the regional peer review committee, subject to his right to have the decision reviewed by the Commission.
(1980, c. 444, § 65.1-159; 1991, c. 355.)
Sections: Previous 65.2-1300 65.2-1301 65.2-1302 65.2-1303 65.2-1304 65.2-1305 65.2-1306 65.2-1307 65.2-1308 65.2-1309 65.2-1310 NextLast modified: April 16, 2009