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Chapter 432E

28 sections

§432E-1 Definitions for health insurance review rules

§432E-1.4 When health plans must cover medical care

§432E-1.5 Managed care plan medical director must be licensed

§432E-2 This law wins when it gives you more protection

§432E-4 Your right to know about treatment choices

§432E-5 Health Plan Complaint and Appeal Rules

§432E-6.5 Fast appeals for urgent health care decisions

§432E-7 What your health plan must tell you

§432E-8 Only the insurance commissioner can enforce managed care rules

§432E-9 How health plans review care quality and use

§432E-10 How health plans must measure and report quality

§432E-11 How managed care plans are checked and accredited

§432E-12 State insurance official must make rules for this law

§432E-13 Annual report on external review cases

§432E-31 Which health plans this law covers

§432E-32 Notice of right to external review

§432E-33 How to ask for an outside review of a health plan decision

§432E-34 How to request an outside review of a health plan denial

§432E-35 Fast-track review of denied health care claims

§432E-36 How to request an outside review of a denied experimental treatment

§432E-37 External review decisions are final

§432E-38 Approval of Independent Review Organizations

§432E-39 Rules for independent review organizations to be approved

§432E-40 Independent review organizations are protected from lawsuits

§432E-41 External review reporting requirements

§432E-42 Who pays for an external review

§432E-43 Health plan must tell members how to appeal a denied service

§432E-44 Insurance commissioner must make rules for external review