America's Affordable Health Choices Act of 2009, October 14, 2009, 111-1 House Report 111-299, Part 1, *2009 |
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... activities on behalf of the plan entity , so long as such activities are conducted in accordance with a utilization review program that meets the requirements of this section . ( 3 ) UTILIZATION REVIEW DEFINED . - For purposes of this ...
... activities on behalf of the plan entity , so long as such activities are conducted in accordance with a utilization review program that meets the requirements of this section . ( 3 ) UTILIZATION REVIEW DEFINED . - For purposes of this ...
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... activities only through personnel who are quali- fied and have received appropriate training in the conduct of such activities under the program . ( B ) PROHIBITION OF CONTINGENT COMPENSATION ARRANGEMENTS . - Such a program shall not ...
... activities only through personnel who are quali- fied and have received appropriate training in the conduct of such activities under the program . ( B ) PROHIBITION OF CONTINGENT COMPENSATION ARRANGEMENTS . - Such a program shall not ...
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... activities . Such contract shall provide that all costs of the process ( except those incurred by the par- ticipant , beneficiary , enrollee , or treating professional in support of the ap- peal ) shall be paid by the plan or entity ...
... activities . Such contract shall provide that all costs of the process ( except those incurred by the par- ticipant , beneficiary , enrollee , or treating professional in support of the ap- peal ) shall be paid by the plan or entity ...
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( B ) The entity conducts external appeal activities through a panel of not fewer than 3 clinical peers . ( C ) The entity has sufficient medical , legal , and other expertise and suffi- cient staffing to conduct external appeal activities ...
( B ) The entity conducts external appeal activities through a panel of not fewer than 3 clinical peers . ( C ) The entity has sufficient medical , legal , and other expertise and suffi- cient staffing to conduct external appeal activities ...
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... activities of the Ombudsman and that include such recommendations for improvement in the administration of this division as the Ombudsman deter- mines appropriate . The Ombudsman shall not serve as an advocate for any in- creases in ...
... activities of the Ombudsman and that include such recommendations for improvement in the administration of this division as the Ombudsman deter- mines appropriate . The Ombudsman shall not serve as an advocate for any in- creases in ...
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111TH CONGRESS administrative Advisory agencies amount applicable appropriate areas assistance authorized Center clause clinical Commissioner Committee Congress contract coordination cost-sharing costs coverage Current Law dual eligibles durable medical equipment employers enactment end the following enrollee enrollment ensure establish evaluation federal fiscal funds GENERAL.-Section grant Health and Human health benefits plan health care Health Insurance Exchange health plan health workforce HIPAA hospital Human Services implement improve individual inserting items and services Law This provision Medicaid medical home Medicare Part D Medicare Prescription Drug ment mental health counselor nursing facility participate patient payment period PHSA sec PHSA section PHSA title physician pilot program premium prescription drug preventive services Proposed Law qualified health benefits quality measures rebate resident respect retary Security Act 42 Social Security Act specified standards striking submit subparagraph subsection Subtitle Task Force telehealth term tion United States Code