Current through Register 1538, January 3, 2025
Section 11.08 - Internal Reviewers(1) The RBPO or ACO shall ensure that an Internal Reviewer determines the resolution of the internal appeal.(2) An Internal Reviewer shall determine whether the Patient has an Urgent Medical Need that warrants an expedited internal appeal. The Internal Reviewer determining Urgent Medical Need and the Internal Reviewer determining the resolution of the internal appeal may be the same individual.Adopted by Mass Register Issue 1373, eff. 9/7/2018.