RS 22:1138 External review register - Louisiana Statutes

§1138.  External review register

A.  An MNRO shall maintain written records in the aggregate and by health insurance issuer and health benefit plan on all requests for external review for which an external review was conducted during a calendar year, hereinafter referred to as the "register".  For each request for external review, the register shall contain, at a minimum, the following information:

(1)  A general description of the reason for the request for external review.

(2)  The date received.

(3)  The date of each review.

(4)  The resolution.

(5)  The date of resolution.

(6)  The name of the covered person for whom the request for external review was filed.

B.  The register shall be maintained in a manner that is reasonably clear and accessible to the commissioner.

C.  The register compiled for a calendar year shall be retained for the longer of three years or until the commissioner has adopted a final report of an examination that contains a review of the register for that calendar year.

D.(1)  The MNRO shall submit to the commissioner, at least annually, a report in the format specified by the commissioner.  The report shall include the following for each health insurance issuer and health benefit plan:

(a)  The total number of requests for external review.

(b)  The number of requests for external review resolved and their  resolution.

(c)  A synopsis of actions being taken to correct problems identified.

(2)  At the time of filing its annual report, an MNRO other than a health insurance issuer shall pay a filing fee in the amount set forth in R.S. 22:821.

Acts 1999, No. 401, §1, eff. Jan. 1, 2000; Redesignated from R.S. 22:3087 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009; Acts 2009, No. 33, §1.

NOTE:  See Acts 1999, No. 401, §2, regarding applicability.

NOTE:  Former R.S. 22:1138 redesignated as R.S. 22:1548 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.