- (a) The Commissioner may conduct an examination of a carrier that has issued a pattern of adverse decisions or grievance decisions for a claim or authorization request for services in, or related to services in, an emergency department.
- (b) A carrier examined under subsection (a) of this section shall produce all documents related to an adverse decision or grievance decision described under subsection (a) of this section, including documents or electronic documents in the possession of a private review agent acting on behalf of the carrier.
(c)
- (1) The Commissioner may have an adverse decision or grievance decision described under subsection (a) of this section reviewed by an independent review organization.
- (2) The costs of a review conducted under paragraph (1) of this subsection shall be paid by the carrier.
Added by Acts 2026, c. 165, § 1, eff. June 1, 2026.