™Your Policy Risk Impact Agent
118 chapters · 1,589 sections in this title.
N.D.C.C. § 26.1-26.4-01 Purpose and scope
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This 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 Afforda…
N.D.C.C. § 26.1-26.4-02 Definitions
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For purposes of this chapter, unless the context requires otherwise: 1. "Commissioner" means the insurance commissioner. 2. "Emergency medical condition" means a medical condition of recent onset and severity, including severe pain, that would lead a prudent layperson acting reas…
N.D.C.C. § 26.1-26.4-03 Certification
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A utilization review agent may not conduct utilization review in this state unless the utilization review agent has certified to the commissioner in writing that the agent is in compliance with section 26.1-26.4-04. Certification must be made annually on or before March first of …
N.D.C.C. § 26.1-26.4-04 Minimum standards of utilization review agents
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All utilization review agents must meet the following minimum standards: 1. Notification of a determination by the utilization review agent must be provided to the enrollee or other appropriate individual in accordance with 29 U.S.C. 1133 and the timeframes set forth in 29 CFR 25…
