La. Admin. Code tit. 37, § XIII-6207 - Approval of Independent Review Organizations (IRO)

A. The commissioner must approve eligible IROs prior to their conducting external reviews or acting in the capacity of an IRO. However, no organization shall be approved as an IRO or added to the list of approved IROs until it has submitted for approval a completed application packet and proof of accreditation by a nationally recognized private accrediting body that maintains accreditation standards equivalent to or higher than the minimum qualifications set forth in R.S. 22:2441. If the commissioner does not approve an IRO, the IRO will be notified of the disapproval in writing.

B. The application packet must include the application completed on the form approved and provided by the commissioner, payment of the initial fee per R.S. 22:821 (B)(37) and all supporting documentation as outlined in the application. Failure to submit all required documentation may result in processing delays or disapproval of the application. To obtain a copy of the IRO application, visit www.ldi.la.gov/industry/company-licensing/application-forms.

C. IRO approvals are effective for two years from the date of approval. A request for re-approval must be submitted on the application form that has been approved by the commissioner and shall be accompanied by the applicable fee. Re-approval applications must be submitted not less than 60 days prior to the expiration of the most current approval.

D. If an approved IRO's specially changes at any point during the two-year period, the IRO must inform the LDI of this change in writing within seven business days of such change.

E. The commissioner will maintain and update the list of approved IROs. However, the commissioner may also revoke approval prior to the expiration of the two-year term, should it be determined that the IRO has lost its accreditation or no longer meets the minimum requirements under R.S. 22:2441. In such case, the IRO will be removed from the list of IROs and must cease conducting reviews. Any reviews that are pending for review by an IRO that has been removed from the list may be reassigned by the commissioner to another IRO.

Notes

La. Admin. Code tit. 37, § XIII-6207

Promulgated by the Department of Insurance, Office of the Commissioner, LR 41:2173 (October 2015).

AUTHORITY NOTE: Promulgated in accordance with R.S. 22:2452.