Section 2164.13. Funding of external review.
(a) Cost.--The insurer against which a request for standard external review or expedited external review under section 2164.5, 2164.6 or 2164.7 is filed shall pay the cost of the IRO to conduct the external review.
(b) Fees.--The fees charged by an IRO shall be reasonable and customary. The department shall annually transmit notice of the fees for the types of adverse benefit determinations under review to the Legislative Reference Bureau for publication in the Pennsylvania Bulletin.
(c) No fee.--A covered person or the covered person's authorized representative may not be charged a fee in order to file a request for external review.
(2164.13 added Nov. 3, 2022, P.L.2068, No.146)