Public-domain · open source
OpenJurist

Idaho Code § 41-5910

Binding nature of external review decision

Known as the Idaho Health Carrier External Review Act

The act spans §§ 41–41 (17 sections).

I.C., § 41-5910, as added by 2009, ch. 87, § 1, p. 240.

(1) For a health care benefit plan not subject to the employee retirement income security act of 1974 (ERISA), the external review decision is final and binding on the health carrier and on the covered person. No judicial action or proceeding arising out of the external review decision or the issues determined by the external review decision shall be permitted. For a health care benefit plan subject to ERISA, the external review decision is final and binding on the health carrier; however, should the covered person seek judicial review of the external review decision, then the external review record and decision shall be included as a part of the administrative record for the purpose of review by any court of competent jurisdiction.

(2) A covered person may not file a subsequent request for external review involving the same adverse benefit determination or final adverse benefit determination for which the covered person has already received an external review decision pursuant to this chapter.

Current official text: Idaho Statutes (Idaho Legislature). Digitized from the UniCourt Code Improvement Commission public-domain capture. Reproduced from public-domain Idaho statutes; confirm against the official source for the current text. Not legal advice.