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The Laws of New York
Consolidated Laws of New York
CHAPTER 45
Public Health
ARTICLE 49
Utilization Review and External Appeal
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ARTICLE 49
Utilization Review and External Appeal
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TITLE 2
Right to External Appeal
This entry was published on 2023-09-08
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TITLE 1
Certification of Agents and Utilization Review Process
Public Health (PBH) CHAPTER 45, ARTICLE 49
SECTION 4900
Definitions
SECTION 4901
Registration of utilization review agents
SECTION 4902
Utilization review program standards
SECTION 4903
Utilization review determinations
SECTION 4903-A
Utilization review determinations for medically fragile children
SECTION 4904
Appeal of adverse determinations by utilization review agents
SECTION 4905
Required and prohibited practices
SECTION 4906
Waiver
SECTION 4907
Rights and remedies
SECTION 4908
Applicability to ERISA Plans
SECTION 4909
Site of service clinical review
TITLE I

CERTIFICATION OF AGENTS AND UTILIZATION REVIEW PROCESS
Section 4900. Definitions.

4901. Registration of utilization review agents.

4902. Utilization review program standards.

4903. Utilization review determinations.

4904. Appeal of adverse determinations by utilization review

agents.

4905. Required and prohibited practices.

4906. Waiver.

4907. Rights and remedies.

4908. Applicability to ERISA Plans.

4909. Site of service clinical review.