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New York Codes Rules Regulations (Last Updated: March 27,2024) |
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TITLE 10. Department of Health |
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Chapter II. Administrative Rules and Regulations |
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Subchapter R. Health Maintenance Organizations |
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Part 98. Health Maintenance Organizations |
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Subpart 98-2. External Appeals of Adverse Determinations |
| 10 CRR-NY II R 98-2 Notes |
| Sec. 98-2.1. Preamble |
| Sec. 98-2.2. Definitions |
| Sec. 98-2.3. Standard description of the external appeal process |
| Sec. 98-2.4. Certification of external appeal agents |
| Sec. 98-2.5. Certification requirements |
| Sec. 98-2.6. Conflict of interest |
| Sec. 98-2.7. Screening of requests for external appeal |
| Sec. 98-2.8. Random assignment of external appeals |
| Sec. 98-2.9. Responsibilities of health care plans |
| Sec. 98-2.10. Responsibilities of certified external appeal agents |
| Sec. 98-2.11. Enrollee rights and responsibilities |
| Sec. 98-2.12. Confidentiality |
| Sec. 98-2.13. Audits and examinations |