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054.00.76-12. Approval of Independent Review Organizations

AR ADC 054.00.76-12Arkansas Administrative Code

West's Arkansas Administrative Code
Title 054. Insurance Department
Division 00.
Rule 76. Arkansas External Review Regulation
Ark. Admin. Code 054.00.76-12
054.00.76-12. Approval of Independent Review Organizations
A. The Commissioner shall approve independent review organizations eligible to be assigned to conduct external reviews under this Rule.
B. In order to be eligible for approval by the Commissioner under this section to conduct external reviews under this Rule an independent review organization:
(1) Except as otherwise provided in this section, shall be accredited by a nationally recognized private accrediting entity that the Commissioner has determined has independent review organization accreditation standards that are equivalent to or exceed the minimum qualifications for independent review organizations established under Section (13) of this Rule; and
(2) Shall submit an application for approval in accordance with Subsection (D) of this Section.
C. The Commissioner shall develop an application form for initially approving and for reapproving independent review organizations to conduct external reviews.
D.(1) Any independent review organization wishing to be approved to conduct external reviews under this Act shall submit the application form and include with the form all documentation and information necessary for the Commissioner to determine if the independent review organization satisfies the minimum qualifications established under Section (13) of this Rule.
(2)(a) Subject to (D)(2)(b) of this Section, an independent review organization is eligible for approval under this section only if it is accredited by a nationally recognized private accrediting entity that the Commissioner has determined has independent review organization accreditation standards that are equivalent to or exceed the minimum qualifications for independent review organizations under Section (13) of this Rule.
(b) The Commissioner may approve independent review organizations that are not accredited by a nationally recognized private accrediting entity if there are no acceptable nationally recognized private accrediting entities providing independent review organization accreditation.
(3) The Commissioner may charge an application fee that independent review organizations shall submit to the commissioner with an application for approval and re-approval.
E.(1) An approval is effective for two (2) years, unless the Commissioner determines before its expiration that the independent review organization is not satisfying the minimum qualifications established under Section (13) of this Rule.
(2) Whenever the Commissioner determines that an independent review organization has lost its accreditation or no longer satisfies the minimum requirements established under Section 13 of this Rule, the commissioner shall terminate the approval of the independent review organization and remove the independent review organization from the list of independent review organizations approved to conduct external reviews under this Rule that is maintained by the Commissioner pursuant to Subsection (F) of this Section.
F. The Commissioner shall maintain and periodically update a list of approved independent review organizations.

Credits

Amended Jan. 6, 2012.
Current with amendments received through February 15, 2024. Some sections may be more current, see credit for details.
Ark. Admin. Code 054.00.76-12, AR ADC 054.00.76-12
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