Screening of Requests for External Review
Effective Sep 7, 2018Mass. Register #1373MGL c. 6D, § 15 MGL c. 6D, § 16 MGL c. 176O, § 24Massachusetts Health Policy Commission
(1) The Office of Patient Protection shall screen all Patient requests for external reviews to determine if they:
- (a) Comply with the requirements of 958 CMR 11.00;
- (b) Do not involve an issue within the purview of the Patient’s Carrier; and
- (c) Result from an RBPO’s or ACO’s written resolution of the internal appeal upholding the decision that is the subject of the appeal; provided, however, that no written resolution is necessary where the RBPO or ACO has failed to comply with timelines for the internal appeals process.