Article 8 - Self-Policing Procedures
- § 1300.67.60 - Standing Referral to HIV/AIDS Specialist. [Renumbered]
- § 1300.68 - Grievance System
- § 1300.68.01 - Expedited Review of Grievances
- § 1300.68.2 - Hospice Services
- § 1300.69 - Public Policy Participation by Subscribers
- § 1300.70 - Health Care Service Plan Quality Assurance Program
- § 1300.70.4 - Independent Medical Reviews Experimental and Investigational Therapies
- § 1300.71 - Claims Settlement Practices
- § 1300.71.31 - Methodology for Determining Average Contracted Rate; Default Reimbursement Rate
- § 1300.71.38 - Fast, Fair and Cost-Effective Dispute Resolution Mechanism
- § 1300.71.39 - Unfair Billing Patterns
- § 1300.71.4 - Emergency Medical Condition and Post-Stabilization Responsibilities for Medically Necessary Health Care Services
- § 1300.73.21 - Arbitration and Settlement Agreements
- § 1300.74.16 - Standing Referral to HIV/AIDS Specialist
- § 1300.74.30 - Independent Medical Review System
- § 1300.74.551 - Scope of Fertility Preservation Services for Iatrogenic Infertility
- § 1300.74.72 - Mental Health and Substance Use Disorder Coverage Requirements
- § 1300.74.72.01 - Scope of Required Benefits for Mental Health and Substance Use Disorders
- § 1300.74.721 - Mental Health and Substance Use Disorder Utilization Review Requirements
- § 1300.74.73 - Pervasive Developmental Disorder and Autism Coverage
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
- § 1300.67.60 - Standing Referral to HIV/AIDS Specialist. [Renumbered]
- § 1300.68 - Grievance System
- § 1300.68.01 - Expedited Review of Grievances
- § 1300.68.2 - Hospice Services
- § 1300.69 - Public Policy Participation by Subscribers
- § 1300.70 - Health Care Service Plan Quality Assurance Program
- § 1300.70.4 - Independent Medical Reviews Experimental and Investigational Therapies
- § 1300.71 - Claims Settlement Practices
- § 1300.71.31 - Methodology for Determining Average Contracted Rate; Default Reimbursement Rate
- § 1300.71.38 - Fast, Fair and Cost-Effective Dispute Resolution Mechanism
- § 1300.71.39 - Unfair Billing Patterns
- § 1300.71.4 - Emergency Medical Condition and Post-Stabilization Responsibilities for Medically Necessary Health Care Services
- § 1300.73.21 - Arbitration and Settlement Agreements
- § 1300.74.16 - Standing Referral to HIV/AIDS Specialist
- § 1300.74.30 - Independent Medical Review System
- § 1300.74.72 - Mental Health and Substance Use Disorder Coverage Requirements
- § 1300.74.72.01 - Scope of Required Benefits for Mental Health and Substance Use Disorders
- § 1300.74.721 - Mental Health and Substance Use Disorder Utilization Review Requirements
- § 1300.74.73 - Pervasive Developmental Disorder and Autism Coverage