Current through 2023 Legislative Sessions
Section 26.1-26.4-01 - Purpose and scopeThis chapter applies to grandfathered health plans unless a health care insurer or utilization review agent determines to extend the protections of section 26.1-36-47 to a grandfathered plan. "Grandfathered health plan" has the meaning stated in the Patient Protection and Affordable Care Act [Pub. L. 111-148], as amended by the Health Care and Education Reconciliation Act of 2010 [Pub. L. 111-152]. The purpose of this chapter is to:
1. Promote the delivery of quality health care in a cost-effective manner;2. Assure that utilization review agents adhere to reasonable standards for conducting utilization review;3. Foster greater coordination and cooperation between health care providers and utilization review agents;4. Improve communications and knowledge of benefits among all parties concerned before expenses are incurred; and5. Ensure that utilization review agents maintain the confidentiality of medical records in accordance with applicable laws.Amended by S.L. 2011 , ch. 218( HB 1127 ), § 2, eff. 7/1/2011.