New Mexico Administrative Code
Title 13 - INSURANCE
Chapter 10 - HEALTH INSURANCE
Part 17 - GRIEVANCE PROCEDURES
- Section 13.10.17.1 - ISSUING AGENCY
- Section 13.10.17.2 - SCOPE
- Section 13.10.17.3 - STATUTORY AUTHORITY
- Section 13.10.17.4 - DURATION
- Section 13.10.17.5 - EFFECTIVE DATE
- Section 13.10.17.6 - OBJECTIVE
- Section 13.10.17.7 - DEFINITIONS
- Section 13.10.17.8 - COMPUTATION OF TIME
- Section 13.10.17.9 - GENERAL REQUIREMENTS REGARDING GRIEVANCE PROCEDURES
- Section 13.10.17.10 - INFORMATION ABOUT GRIEVANCE PROCEDURES
- Section 13.10.17.11 - RESERVED
- Section 13.10.17.12 - NOTICE OF INITIAL DETERMINATION
- Section 13.10.17.13 - PRELIMINARY DETERMINATION OF GRIEVANCE
- Section 13.10.17.14 - INTERNAL FIRST LEVEL REVIEW OF ADVERSE DETERMINATIONS
- Section 13.10.17.15 - NOTICE FOLLOWING FIRST LEVEL INTERNAL REVIEW OF ADVERSE DETERMINATIONS
- Section 13.10.17.16 - INTERNAL PANEL REVIEW OF ADVERSE DETERMINATIONS
- Section 13.10.17.17 - NOTICE OF INTERNAL PANEL REVIEW DECISION
- Section 13.10.17.18 - ADDITIONAL REVIEW BY ENTITIES SUBJECT TO THE NEW MEXICO HEALTH CARE PURCHASING ACT
- Section 13.10.17.19 - IRO REVIEW OF AN ADVERSE DETERMINATION
- Section 13.10.17.20 - QUALIFICATIONS OF IROs AND APPROVAL BY SUPERINTENDENT
- Section 13.10.17.21 - INITIATING AN IRO REVIEW OF AN ADVERSE DETERMINATION
- Section 13.10.17.22 - TIMEFRAMES AND PROCESSES FOR IRO REVIEW
- Section 13.10.17.23 - THE FINAL DECISION OF THE IRO AND GRIEVANT'S RIGHT TO HEARING AFTER FINAL IRO DECISION
- Section 13.10.17.24 - SUPERINTENDENT'S HEARING PROCEDURES FOR ADVERSE DETERMINATIONS
- Section 13.10.17.25 - INDEPENDENT CO-HEARING OFFICERS (ICOS)
- Section 13.10.17.26 - SUPERINTENDENT'S DECISION ON EXTERNAL REVIEW OF ADVERSE DETERMINATION
- Section 13.10.17.27 - INTERNAL REVIEW OF ADMINISTRATIVE GRIEVANCES
- Section 13.10.17.28 - RECONSIDERATION OF INTERNAL REVIEW OF ADMINISTRATIVE GRIEVANCE
- Section 13.10.17.29 - DECISION OF RECONSIDERATION COMMITTEE
- Section 13.10.17.30 - EXTERNAL REVIEW OF ADMINISTRATIVE GRIEVANCES BY SUPERINTENDENT
- Section 13.10.17.31 - REQUIREMENTS FOR EXTERNAL REVIEW OF ADMINISTRATIVE GRIEVANCE
- Section 13.10.17.32 - ACKNOWLEDGEMENT OF REQUEST FOR EXTERNAL REVIEW OF ADMINISTRATIVE GRIEVANCE BY SUPERINTEDENT
- Section 13.10.17.33 - REVIEW OF ADMINISTRATIVE GRIEVANCE BY SUPERINTENDENT
- Section 13.10.17.34 - CONFIDENTIALITY OF A GRIEVANT'S RECORDS AND MEDICAL INFORMATION
- Section 13.10.17.35 - RECORD OF GRIEVANCES
Current through Register Vol. 35, No. 18, September 24, 2024
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