Utah Admin. Code R590-261-2 - Purpose and Scope
(1) The purpose of
this rule is to provide a uniform standard for the establishment and
maintenance of an independent review procedure to assure that a claimant has
the opportunity for an independent review of a final adverse benefit
determination.
(2)
(a) This rule applies to a carrier offering a
health benefit plan.
(b) This rule
does not apply to a grandfathered health plan.
(c) If all grandfathered health benefit plans
are administered consistently, a carrier may voluntarily comply with the
independent review process outlined in this rule.
(d) A self-funded health plan may voluntarily
comply with the independent review process outlined in this rule.
Notes
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