Source: http://regulations.delaware.gov/register/february2007/emergency/10%20DE%20Reg%201180%2002-01-07.htm
Timestamp: 2017-12-17 19:42:00
Document Index: 649252147

Matched Legal Cases: ['§10115', '§ 311', '§ 10115', '§332', '§3349', '§ 311']

10 DE Reg 1180 02-01-07
1. Regulation 1301 as currently promulgated is rescinded and the attached amended version of Regulation 1301 is substituted in lieu thereof effective January 6, 2007.
2. This order shall be effective until April 30, 2007 or until the attached amendment to Regulation 1301 is adopted pursuant to the Delaware Administrative Procedures Act whichever shall first occur. The Department will receive, consider and respond to petitions by any interested person for the reconsideration or revision of the emergency regulation.
3. The Department gives public notice of the proposed amendment to Regulation 1301 as required by 29 Del.C. §10115 as follows:
The Department of Insurance proposes to amend Regulation 1301 by rescinding the current regulation and substituting in lieu thereof revised provisions for the review and arbitration of health insurance claims. As a result of the enactment of Senate Bill 295 on July 6, 2006, it became necessary to re-promulgate Regulation 1301 to provide for the review of claims from managed care organizations formerly under the regulatory authority of the Department of Health and Social Services. The Delaware Code authority for the change is 18 Del.C. §§ 311, 332 and 6401 et seq. The text can also be viewed at the Delaware Insurance Commissioner's website at www.delawareinsurance.gov and clicking on the link for "Proposed Regulations."
4. Since the wording of the attached emergency regulation is identical to the wording the Department intends to adopt as a final regulation, public comment on the emergency regulation shall be deemed to be public comment on the proposed regulation as would otherwise be permitted under 29 Del.C. § 10115.
1.1 The purpose of this Regulation is to implement 18 Del.C. §§332, 6416 and 6417 which require health insurance carriers to establish a procedure for internal review of a carrier’s adverse coverage determination and which require the Delaware Insurance Department to establish and administer procedures for arbitration and independent utilization review upon completion of the carrier’s internal review process. This Regulation also implements 18 Del.C. §§3349 and 3565, which require the Delaware Insurance Department to establish and administer procedures for arbitration of disputes between health insurance carriers and non-network providers of emergency care services. This Regulation is promulgated pursuant to 18 Del.C. §§ 311, 332, 3349, 3565 and 6408 and 29 Del.C., Ch. 101. This Regulation should not be construed to create any cause of action not otherwise existing at law.
10 DE Reg. 1180 (02/01/07) (Emer.)