(I.1) Adverse Benefit Determinations
- § 991.2164. Internal Adverse Benefit Determination Process for Insurer
- § 991.2164a. External Review Applicability and Scope
- § 991.2164b. Notice of Right to External Review
- § 991.2164c. Request for External Review
- § 991.2164d. Exhaustion of Internal Appeal Process
- § 991.2164e. Standard External Review
- § 991.2164f. Expedited External Review
- § 991.2164g. External Review of Experimental or Investigational Treatment Adverse Benefit Determinations
- § 991.2164h. Binding Nature of External Review Decision
- § 991.2164i. Department Approval of Independent Review Organizations
- § 991.2164j. Minimum Qualifications for Independent Review Organizations
- § 991.2164k. Hold Harmless for Independent Review Organizations
- § 991.2164l. External Review Reporting Requirements
- § 991.2164m. Funding of External Review
- § 991.2164n. Availability of Forms