Expedited integrated organization determinations.

Expedited integrated organization determinations.
(1) An enrollee, or a provider on behalf of an enrollee, may request an expedited integrated organization determination.
(2) The request can be oral or in writing.
(3) The applicable integrated plan must complete an expedited integrated organization determination when the applicable integrated plan determines (based on a request from the enrollee or on its own) or the provider indicates (in making the request on the enrollee's behalf or supporting the enrollee's request) that taking the time for a standard resolution could seriously jeopardize the enrollee's life, physical or mental health, or ability to attain, maintain, or regain maximum function.


42 CFR § 422.631

Scoping language

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