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Grievances and External Reviews | Midpage
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Connecticut General Statutes
Title 38a
Chapter 700c
Part VII
Grievances and External Reviews
38a-591
Compliance with the Patient Protection and Affordable Care Act. Regulations.
38a-591a
*(See end of section for amended version of subdivision (7) and effective date.) Definitions.
38a-591b
Health carrier responsibilities re utilization review.
38a-591c
Utilization review criteria and procedures.
38a-591d
Utilization review and benefit determinations. Urgent care requests. Information provided in notice of adverse determination.
38a-591e
Internal grievance process of adverse determinations based on medical necessity. Expedited review of adverse determinations of urgent care requests.
38a-591f
Internal grievance process of adverse determinations not based on medical necessity.
38a-591g
External reviews and expedited external reviews.
38a-591h
Record-keeping requirements. Report to commissioner upon request.
38a-591i
Regulations.
38a-591j
Utilization review companies: Licensure. Fees. Investigation of grievances. Duties.
38a-591k
Violations. Notice and hearing. Penalties. Appeal.
38a-591l
Independent review organizations conducting external reviews and expedited external reviews.
38a-591m
Independent review organizations: Conflicts of interest. Liability. Record-keeping requirements. Report to commissioner upon request.
38a-591n
Documents, communications, information and evidence provided to covered person or covered person's authorized representative upon request.
38a-591o
Restrictions applicable to prospective or concurrent review of certain recurring prescription drugs. Exceptions.
38a-592 to 38a-594
Conn. Gen. Stat. § 38a-592 to 38a-594