958 CMR, § 11.15

Current through Register 1538, January 3, 2025
Section 11.15 - Screening of Requests for External Review
(1) The Office of Patient Protection shall screen all Patient requests for external reviews to determine if they:
(a) Comply with the requirements of 958 CMR 11.00;
(b) Do not involve an issue within the purview of the Patient's Carrier; and
(c) Result from an RBPO's or ACO's written resolution of the internal appeal upholding the decision that is the subject of the appeal; provided, however, that no written resolution is necessary where the RBPO or ACO has failed to comply with timelines for the internal appeals process.

958 CMR, § 11.15

Adopted by Mass Register Issue 1373, eff. 9/7/2018.