ARTICLE 5.55. Appeals Seeking Independent Medical Reviews [1374.30. - 1374.36.]

Article 5.55 added by Stats. 1999, Ch. 533, Sec. 1.

§§ 1374.30–1374.36 · 7 sections

• § 1374.30 (a) Commencing January 1, 2001, there is hereby established in the department the Independent Medical Review System. (b) For the purposes of this chapter,…
• § 1374.31 (a) If there is an imminent and serious threat to the health of the enrollee, as specified in subdivision (c) of Section 1374.33, all necessary information and…
• § 1374.32 (a) The department shall contract with one or more independent medical review organizations in the state to conduct reviews for purposes of this article. The…
• § 1374.33 (a) Upon receipt of information and documents related to a case, the medical professional reviewer or reviewers selected to conduct the review by the…
• § 1374.34 (a) Upon receiving the decision adopted by the director pursuant to Section 1374.33 that a disputed health care service is medically necessary, the plan shall…
• § 1374.35 (a) After considering the results of a competitive bidding process and any other relevant information on program costs, the director shall establish a…
• § 1374.36 (a) The director shall submit to the Legislature by March 1, 2002, a report on the initial implementation of this article. The report shall include a…