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Chapter 284-43A WAC

Last Update: 12/19/22

INDEPENDENT REVIEW ORGANIZATIONS (IROs)

WAC Sections

SUBCHAPTER A
GENERAL PROVISIONS
HTMLPDF284-43A-001Purpose and scope.
HTMLPDF284-43A-010Definitions.
SUBCHAPTER B
CERTIFICATION AND REQUIREMENTS FOR INDEPENDENT REVIEW ORGANIZATIONS (IROs)
HTMLPDF284-43A-020General requirements for certification.
HTMLPDF284-43A-030Application for certification as an IRO.
HTMLPDF284-43A-040Administrative processes and capabilities of IROs.
HTMLPDF284-43A-050Conflict of interest.
HTMLPDF284-43A-060Expert reviewers.
HTMLPDF284-43A-070Independent review process.
HTMLPDF284-43A-080Criteria and considerations for independent review determinations.
HTMLPDF284-43A-090Additional requirements for experimental or investigational treatment reviews.
HTMLPDF284-43A-100Ongoing requirements for IROs.
HTMLPDF284-43A-110Powers of the commissioner.
HTMLPDF284-43A-120Grounds for action against an applicant or a certified IRO.
HTMLPDF284-43A-130Maximum fee schedule.
SUBCHAPTER C
REQUIREMENTS FOR CARRIERS IN USING INDEPENDENT REVIEW ORGANIZATIONS (IROs)
HTMLPDF284-43A-140External review of adverse benefit determinations.
HTMLPDF284-43A-150Independent review of adverse determinations.