Pennsylvania Pennsylvania ER – 10.15.19 I. Scope and Applicability A. Who is subject to the state’s external review laws? All entities conducting reviews and appeals of complaint and grievances under Act 68. 28 Pa. Code § 9.701 HMOs? Yes. Insurers? Yes. Utilization review organizations? Yes. ACOs? Yes. PPOs? Yes. Third party administrators? Yes. B. What […]
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