The Department shall promulgate regulations, pursuant to the AdministrativeProcess Act (§ 2.2-4000 et seq.), to implement the provisions of thisarticle, which shall include, but not be limited to, the following items:
1. Minimum qualifications to perform review;
2. Procedures which require the private review agent to provide the attendingphysician an opportunity to consult with a physician advisor prior toissuance of a final denial in any case in which there is an initialrecommendation to deny coverage;
3. Guidelines regarding access to and confidentiality of patient-specificmedical records and information; and
4. Setting the amount of any fees required by this article, which shall besufficient to pay for the administrative costs of regulation under thisarticle.
The Department shall promulgate regulations, pursuant to the AdministrativeProcess Act (§ 2.2-4000 et seq.), to implement the provisions of thisarticle, which shall include, but not be limited to, the following items:
1. Minimum qualifications to perform review;
2. Procedures which require the private review agent to provide the attendingphysician an opportunity to consult with a physician advisor prior toissuance of a final denial in any case in which there is an initialrecommendation to deny coverage;
3. Guidelines regarding access to and confidentiality of patient-specificmedical records and information; and
4. Setting the amount of any fees required by this article, which shall besufficient to pay for the administrative costs of regulation under thisarticle.
The Department shall promulgate regulations, pursuant to the AdministrativeProcess Act (§ 2.2-4000 et seq.), to implement the provisions of thisarticle, which shall include, but not be limited to, the following items:
1. Minimum qualifications to perform review;
2. Procedures which require the private review agent to provide the attendingphysician an opportunity to consult with a physician advisor prior toissuance of a final denial in any case in which there is an initialrecommendation to deny coverage;
3. Guidelines regarding access to and confidentiality of patient-specificmedical records and information; and
4. Setting the amount of any fees required by this article, which shall besufficient to pay for the administrative costs of regulation under thisarticle.