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  1. LII
  2. State Regulations
  3. Virginia Administrative Code
  4. Title 12 - HEALTH
  5. Agency 5 - DEPARTMENT OF HEALTH
  6. Chapter 405 - RULES GOVERNING PRIVATE REVIEW AGENTS

Chapter 405 - RULES GOVERNING PRIVATE REVIEW AGENTS

  • State Regulations
  • Compare
  1. § 12VAC5-405-10 - Purpose
  2. § 12VAC5-405-20 - Reserved
  3. § 12VAC5-405-30 - Scope
  4. § 12VAC5-405-40 - Definitions
  5. § 12VAC5-405-50 - Certificates to perform utilization review
  6. § 12VAC5-405-60 - Fee for certificate
  7. § 12VAC5-405-70 - Minimum qualifications of staff
  8. § 12VAC5-405-80 - Adverse decisions
  9. § 12VAC5-405-90 - Appeals of adverse decisions
  10. § 12VAC5-405-100 - Access to and confidentiality of medical records and information
  11. § 12VAC5-405-110 - Accessibility
  12. § 12VAC5-405-120 - Examination of private review agents
  13. Form - FORMS (12VAC5-405)

The following state regulations pages link to this page.



State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.


  1. 12VAC5-405-10 - Purpose.
  2. 12VAC5-405-20 - [Reserved].
  3. 12VAC5-405-30 - Scope.
  4. 12VAC5-405-40 - Definitions.
  5. 12VAC5-405-50 - Certificates to perform utilization review.
  6. 12VAC5-405-60 - Fee for certificate.
  7. 12VAC5-405-70 - Minimum qualifications of staff.
  8. 12VAC5-405-80 - Adverse decisions.
  9. 12VAC5-405-90 - Appeals of adverse decisions.
  10. 12VAC5-405-100 - Access to and confidentiality of medical records and information.
  11. 12VAC5-405-110 - Accessibility.
  12. 12VAC5-405-120 - Examination of private review agents.
  13. FORMS - FORMS (12VAC5-405)

State Regulations Toolbox

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