§ 32.1-138.9 — Standards for approval

Virginia § 32.1-138.9

• Jurisdiction: Virginia
• Title 32.1: HEALTH
• Ch. 5: REGULATION OF MEDICAL CARE FACILITIES AND SERVICES
• Art. 2.1: PRIVATE REVIEW AGENTS

Text

Each private review agent shall file an application with the Department which shall meet the following minimum standards and any additional standards established by regulation pursuant to § 32.1-138.15, and pay a filing fee established by the Department, in order to be approved by the Department:

1. A description of the procedures to be used in evaluating proposed or delivered hospital, medical, or other health care services;

2. The procedures by which patients or providers may seek reconsideration of determinations by private review agents;

3. The type and qualifications of the personnel either employed or under contract to perform the utilization review;

4. Procedures and policies which ensure that patient-specific medical records and information shall be kept strictly confidential except as authorized by the patient or by regulations adopted pursuant to this article; and

5. Assurances that reviewers be readily accessible by telephone to patients and providers at least forty hours per week during normal business hours.

Legislative History

1990, c. 826, § 38.2-5302; 1998, c. 129.