§ 4916 — Oversight and surveillance of the external appeal process

§ 4916. Oversight and surveillance of the external appeal process. 1.\nThe commissioner shall have the power to:\n (a) review the activities of the health care plans and external appeal\nagents pursuant to this title, including the extent to which such plans\nand agents adhere to the standards and time frames required pursuant to\nthis title;\n (b) investigate complaints by enrollees regarding requests for and\nprocessing of external appeals; and\n (c) conduct random audits of health care plans and external appeal\nagents to determine compliance with the provisions of this title.\n 2. Each health care plan and external appeal agent shall annually, in\nsuch form as the commissioner shall require, report the number of\nexternal appeals requested by enrollees and the outcomes of any such\nexternal appeals.\n 3. The commissioner shall annually report, by plan and agent, such\ninformation to the governor and the legislature, provided that no such\ninformation shall be included which would otherwise be deemed\nconfidential information within the meaning of this chapter.\n