32.1-138.15 - Regulations. - Virginia Statutes

§ 32.1-138.15. Regulations.

The Department shall promulgate regulations, pursuant to the AdministrativeProcess Act (§ 2.2-4000 et seq.), to implement the provisions of thisarticle, which shall include, but not be limited to, the following items:

1. Minimum qualifications to perform review;

2. Procedures which require the private review agent to provide the attendingphysician an opportunity to consult with a physician advisor prior toissuance of a final denial in any case in which there is an initialrecommendation to deny coverage;

3. Guidelines regarding access to and confidentiality of patient-specificmedical records and information; and

4. Setting the amount of any fees required by this article, which shall besufficient to pay for the administrative costs of regulation under thisarticle.

(1990, c. 826, § 38.2-5309; 1998, c. 129.)