4910 – Right to External Appeal Established.
§ 4910. Right to external appeal established. 1. There is hereby established an enrollee’s right to an external appeal of a final adverse determination by a health care plan. 2. An enrollee, the enrollee’s designee and, in connection with concurrent and retrospective adverse determinations, an enrollee’s health care provider, shall have the right to request […]
4911 – Powers of the Commissioner.
§ 4911. Powers of the commissioner. 1. The commissioner shall have the power to grant and revoke certifications of external appeal agents to conduct external appeals requested pursuant to either paragraph (a) or (b) of subdivision two of section forty-nine hundred ten of this title or pursuant to both such paragraphs. 2. If, after reviewing […]