CHAPTER 20A - MANAGED HEALTH CARE PLANS
- ARTICLE 1 - PATIENT PROTECTION
- § 33-20A-1 - Short title
- § 33-20A-10 - Chapter inapplicable to workers' compensation provisions
- § 33-20A-2 - Legislative findings
- § 33-20A-3 - Definitions
- § 33-20A-4 - Certification requirements; review and recertification; sanctions for failure to meet requirements; alternative methods for certification
- § 33-20A-5 - Standards for certification
- § 33-20A-6 - Financial incentive programs prohibited; capitated payment arrangement allowed
- § 33-20A-7 - Penalizing provider for discussing necessary or appropriate care with patient prohibited; penalty for providing records and assistance prohibited; penalty for violations
- § 33-20A-7.1 - Application; managed care plan's liability following precertification; availability of personnel for precertification procedure
- § 33-20A-8 - Confidentiality and accuracy of patient records
- § 33-20A-9 - Emergency services requirements; restrictive formulary requirements
- § 33-20A-9.1 - Legislative intent; consumer choice option; provisions; increased expenses; covered benefits; forms
- § TITLE 33 Chapter 20A Article 1
- ARTICLE 2 - PATIENT'S RIGHT TO INDEPENDENT REVIEW
- § 33-20A-30 - Short title
- § 33-20A-31 - Definitions
- § 33-20A-32 - Right to appeal
- § 33-20A-33 - Minimum expense of treatment prior to review
- § 33-20A-34 - Representatives for enrollee; cost of review; cooperation
- § 33-20A-35 - Request for independent review
- § 33-20A-36 - Additional information required for independent review
- § 33-20A-37 - Effect of favorable determinations
- § 33-20A-38 - Organizational and employee liability
- § 33-20A-39 - Certification of independent review organizations; conflict of interest; quality assurance mechanism; copies of nonproprietary information
- § 33-20A-40 - Determining medical necessity or whether a treatment is experimental
- § 33-20A-41 - Rules and regulations
- § 33-20A-42 - Grievance procedures and hearings for Medicaid care management members
- § TITLE 33 Chapter 20A Article 2
- ARTICLE 3 - MANAGED HEALTH CARE PLANS
- ARTICLE 4 - JOINT COMMITTEE TO STUDY PRESCRIPTION COSTS IN STATE FUNDED HEALTH CARE PLANS