Section 550.1903 – Definitions.
550.1903 Definitions. Sec. 3. As used in this act: (a) “Adverse determination” means a determination by a health carrier or its designee utilization review organization that an admission, availability of care, continued stay, or other health care service that is a covered benefit has been reviewed and, based on the information provided, does not meet […]
Section 550.1905 – Scope.
550.1905 Scope. Sec. 5. (1) Except as otherwise provided in subsection (2), this act applies to all health carriers. (2) This act does not apply to a policy or certificate that provides coverage only for specified accident or accident-only coverage, credit, disability income, hospital indemnity, long-term care insurance, as that term is defined in section […]
Section 550.1907 – Right to Request External Review for Adverse Determination; Written Notice.
550.1907 Right to request external review for adverse determination; written notice. Sec. 7. (1) A health carrier shall provide written notice to a covered person of the internal grievance and external review processes at the time the health carrier sends written notice of an adverse determination. (2) Except as provided in subsection (3)(a), a request […]
Section 550.1909 – Written Request to Director; Manner; Electronic Communication.
550.1909 Written request to director; manner; electronic communication. Sec. 9. (1) Except for a request for an expedited external review under section 13, all requests for external review must be made in writing to the director. (2) A written notice required to be provided under this act must be provided in a culturally and linguistically […]
Section 550.1901 – Short Title.
550.1901 Short title. Sec. 1. This act shall be known and may be cited as the “patient’s right to independent review act”. History: 2000, Act 251, Eff. Oct. 1, 2000