| §19.1701 |
General Provisions |
| §19.1702 |
Applicability |
| §19.1703 |
Definitions |
| §19.1704 |
Certification or Registration of URAs |
| §19.1705 |
General Standards of Utilization Review |
| §19.1706 |
Requirements and Prohibitions Relating to Personnel |
| §19.1707 |
URA Contact with and Receipt of Information from Health Care Providers |
| §19.1708 |
On-Site Review by a URA |
| §19.1709 |
Notice of Determinations Made in Utilization Review |
| §19.1710 |
Requirements Prior to Issuing an Adverse Determination |
| §19.1711 |
Written Procedures for Appeal of Adverse Determinations |
| §19.1712 |
URA's Telephone Access |
| §19.1713 |
Confidentiality |
| §19.1714 |
Regulatory Requirements Subsequent to Certification or Registration |
| §19.1715 |
Administrative Violations |
| §19.1716 |
Specialty URA |
| §19.1717 |
Independent Review of Adverse Determinations |
| §19.1718 |
Preauthorization for Health Maintenance Organizations and Preferred Provider Benefit Plans |
| §19.1719 |
Verification for Health Maintenance Organizations and Preferred Provider Benefit Plans |
| §19.1730 |
Definitions |
| §19.1731 |
Preauthorization Exemption |
| §19.1732 |
Notice of Preauthorization Exemption Grants, Denials, or Rescissions |
| §19.1733 |
Retrospective Reviews and Appeals of Preauthorization Exemption Rescissions |
