Current through Register Vol. 35, No. 18, September 24, 2024
A.
Applicability of internal panel
review.
(1) A health care insurer that
offers managed health care plans shall establish a panel review process for its
managed health care plans to give those grievants who are dissatisfied with the
internal review decision the option to request a panel review, at which the
grievant has the right to appear in person before a panel of designated
representatives of the health care insurer.
(2) This section also applies to persons
covered under the New Mexico Health Care Purchasing Act (public employees and
retirees, public school employees and retirees only).
B.
Acknowledgment of request.
Upon receipt of a request for internal panel review of an adverse
determination, the health care insurer shall date and time stamp the request
and:
(1) for a standard internal panel review,
within three working days after receipt of the request, send the grievant an
acknowledgment that the request has been received; or
(2) for an expedited internal panel review,
acknowledge the request telephonically or by electronic communication;
and
(3) the acknowledgment shall:
(a) contain the name, address and direct
telephone number of an individual representative of the health care insurer who
may be contacted regarding the grievance;
(b) specify the date, time and location for
the internal panel review meeting and provide a toll-free number for the
grievant to participate telephonically;
(c) include the grievant's rights as set
forth below; and
(d) inform the
grievant if the health care insurer will be represented by an
attorney.
C.
Grievant's rights. The health care insurer shall notify the
grievant of the grievant's right to:
(1)
request the opportunity to appear in person or telephonically before an
internal review panel comprised of the health care insurer's designated
representatives;
(2) present the
grievant's case to the internal review panel orally or in writing;
(3) submit written comments, documents,
records, and other material relating to the request for benefits for the
internal review panel to consider when conducting the review both before and,
if applicable, at the review panel's meeting;
(4) if applicable, ask questions of any
representative of the health care insurer or health care professional on the
internal review panel;
(5) be
assisted or represented by an individual of the grievant's choice, including
legal representation at the grievant's expense;
(6) hire a specialist to participate in the
internal panel review at the grievant's expense, but such specialist may not
participate in making the decision; and
(7) request a postponement of the internal
panel review for up to 30 days.
D.
Conduct of the internal panel
review.
(1) Upon receipt of a
grievant's request for an internal panel review, the health care insurer shall
appoint a panel to review the request.
(a)
The health care insurer shall select representatives of the health care insurer
and if the adverse determination was based on a determination that the
requested service is not a medical necessity, is experimental or
investigational, or is considered not a covered benefit, one or more qualified
health care professionals shall serve on the internal review panel. At least
one of the health care professionals selected shall be a clinical peer that
practices in a specialty that would typically manage the case that is the
subject of the grievance or be mutually agreed upon by the grievant and the
health care insurer.
(b) A panel
shall be comprised of individuals who have no financial interest in the outcome
of the review and who were not involved in the initial determination or the
first internal review decision, except that an individual who was involved in
the first internal review decision may appear before the panel to present
information or answer questions.
(2) In conducting the review, the internal
review panel shall take into consideration all comments, documents, records and
other information regarding the request for benefits submitted by the grievant,
without regard to whether the information was submitted or considered in
reaching the initial determination or the first internal review
decision.
(3) The internal review
panel shall have the legal authority to bind the health care insurer to the
panel's decision.
(4) If the
initial adverse determination was based on a lack of coverage, the internal
review panel shall review the health benefits plan and determine whether there
is any provision in the plan under which the requested health care service
could be certified. If the internal review panel finds that the requested
health care benefit is not covered by the health benefits plan, the panel shall
issue its final adverse determination in accordance with this rule.
(5) If the initial adverse determination was
based on a determination that the requested service is experimental,
investigational or not a medical necessity, the internal review panel shall
render an opinion, either after consultation with specialists who are experts
in the area that is the subject of review, or after application of uniform
standards used by the health care insurer.
(6) Internal review panel members must be
physically present or attend the panel by video or telephone conferencing to
participate in the decision.
E.
Information to grievant. No
fewer than three days prior to the internal panel review, the health care
insurer shall provide to the grievant copies of all documents that will be
considered in reviewing the grievant's request for benefits, including, if
applicable:
(1) the grievant's pertinent
medical records;
(2) the treating
provider's recommendation;
(3)
relevant sections of the grievant's health benefits plan;
(4) the health care insurer's notice of
adverse determination;
(5) uniform
standards relevant to the grievant's medical condition that shall be used by
the internal panel in reviewing the adverse determination;
(6) questions sent to or reports received
from any medical consultants retained by the health care insurer; and
(7) all other evidence or documentation
relevant to reviewing the adverse determination.
F.
Request for postponement. The
health care insurer shall not unreasonably deny a request for postponement of
the internal panel review for up to 30 days made by the grievant. The
timeframes for completing the internal panel review shall be extended during
the period of any postponement.
G.
Additional requirements for expedited internal panel review of an adverse
determination.
(1) In an expedited
review, all information required to be exchanged by Section E. of 13.10.17.16
NMAC shall be transmitted between the health care insurer and the grievant by
the most expedient method available.
(2) If an expedited review is conducted
during a grievant's hospital stay or approved on-going course of treatment,
health care services shall be continued without cost (except for applicable
co-payments, co-insurance and deductibles) to the grievant until the health
care insurer makes a final decision and notifies the grievant.
(3) A health care insurer shall not conduct
an expedited internal panel review of post-service claims.