Washington Administrative Code
2023 Archive

Chapter 284-43A WAC
Last Update: 12/19/22

INDEPENDENT REVIEW ORGANIZATIONS (IROs)
PDF of Chapter Digest
WAC Sections
SUBCHAPTER A
GENERAL PROVISIONS
284-43A-001Purpose and scope.
284-43A-010Definitions.
SUBCHAPTER B
CERTIFICATION AND REQUIREMENTS FOR INDEPENDENT REVIEW ORGANIZATIONS (IROs)
284-43A-020General requirements for certification.
284-43A-030Application for certification as an IRO.
284-43A-040Administrative processes and capabilities of IROs.
284-43A-050Conflict of interest.
284-43A-060Expert reviewers.
284-43A-070Independent review process.
284-43A-080Criteria and considerations for independent review determinations.
284-43A-090Additional requirements for experimental or investigational treatment reviews.
284-43A-100Ongoing requirements for IROs.
284-43A-110Powers of the commissioner.
284-43A-120Grounds for action against an applicant or a certified IRO.
284-43A-130Maximum fee schedule.
SUBCHAPTER C
REQUIREMENTS FOR CARRIERS IN USING INDEPENDENT REVIEW ORGANIZATIONS (IROs)
284-43A-140External review of adverse benefit determinations.
284-43A-150Independent review of adverse determinations.