CHAPTER 420-J — MANAGED CARE LAW
- Section 420-J:1 Purpose and Intent.
- Section 420-J:2 Applicability and Scope.
- Section 420-J:3 Definitions.
- Section 420-J:3-a Access to Enhanced 911 System.
- Section 420-J:3-b Pre-certification Requirement.
- Section 420-J:4 Credentialing Verification Procedures.
- Section 420-J:5 Grievance Procedures.
- Section 420-J:5-a Right to External Review.
- Section 420-J:5-b Standard External Review.
- Section 420-J:5-c Expedited External Review.
- Section 420-J:5-d Certification of Independent Review Organizations.
- Section 420-J:5-e General Provisions Regarding External Review.
- Section 420-J:6 Utilization Review.
- Section 420-J:6-a Obstetrical-Gynecological Coverage.
- Section 420-J:6-b Self-referrals for Chiropractic Care.
- Section 420-J:6-c Third-Party Payment of Covered, Court-Ordered Services.
- Section 420-J:6-d Coverage for Dependents.
- Section 420-J:7 Network Adequacy.
- Section 420-J:7-a Filing Requirements for Medical Necessity Definitions.
- Section 420-J:7-b Prescription Drugs.
- Section 420-J:7-c Disqualification of Certain Physicians Prohibited.
- Section 420-J:7-d Continued Access to Care Subsequent to a Provider Contract Termination.
- Section 420-J:8 Provider Contract Standards.
- Section 420-J:8-a Prompt Payment Required.
- Section 420-J:8-b Retroactive Denials Prohibited; Exceptions.
- Section 420-J:8-c Reimbursement for Providers Waiting for Health Carrier Credentialing Verification.
- Section 420-J:8-d Dependent Coverage.
- Section 420-J:9 Quality Assessment, Quality Improvement, and Reporting.
- Section 420-J:10 Confidentiality of Insurer Records.
- Section 420-J:11 Confidentiality of Insurance Department Records.
- Section 420-J:12 Rulemaking Authority.
- Section 420-J:13 Severability.
- Section 420-J:14 Penalties.