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Registration of Agents and Review Process
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Utilization Review and External Appeal
Registration of Agents and Review Process
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Section
4900
Definitions.
Section
4901
Reporting Requirements for Utilization Review Agents.
Section
4902
Utilization Review Program Standards.
Section
4903
Utilization Review Determinations.
Section
4904
Appeal of Adverse Determinations by Utilization Review Agents.
Section
4905
Required and Prohibited Practices.
Section
4906
Waiver.
Section
4907
Rights and Remedies.
Section
4908
Applicability to Erisa Plans.