Private Insurance Data Requirements in Idaho
Private Insurance Data Requirements in Idaho
| Subtopic | Statute/Regulation | Description |
|---|
| Disclosure of information held by health plan, including notice requirements | Idaho Admin. Code r. 18.04.01.020, Notice of Right to External Review | Requires health carriers to provide covered persons with notice of their external review procedures. Permits such notice to accompany the policy,... |
| Idaho Admin. Code r. 18.04.01.021, Request for External Review | Requires the Department of Insurance to make an external review request form available on the Department’s website. Requires covered persons to... | |
| Idaho Admin. Code r. 18.04.01.022, Health Carrier Notice of an Initial Determination of an External Review | Requires health carriers to send notice of an initial determination of an external review using a from that complies with the language in Appendix C... | |
| Idaho Code Ann. § 41-5916, Disclosure Requirements | Specifies the information about external review procedures that health carriers must include in policies, certificates, and other evidences of... |
| Grievance procedures | Idaho Admin. Code r. 18.04.01.020, Notice of Right to External Review | Requires health carriers to provide covered persons with notice of their external review procedures. Permits such notice to accompany the policy,... |
| Idaho Admin. Code r. 18.04.01.021, Request for External Review | Requires the Department of Insurance to make an external review request form available on the Department’s website. Requires covered persons to... | |
| Idaho Admin. Code r. 18.04.01.022, Health Carrier Notice of an Initial Determination of an External Review | Requires health carriers to send notice of an initial determination of an external review using a from that complies with the language in Appendix C... | |
| Idaho Code Ann. § 41-3918, Grievance System | Requires Managed Care Organizations (MCOs) to implement a grievance system that has received approval from the Insurance Director. Requires MCOs to... | |
| Idaho Code Ann. § 41-3930, Utilization Management Program Requirements | Establishes requirements for utilization management programs conducted by Managed Care Organizations (MCOs) or their contractors. Requires MCO... | |
| Idaho Code Ann. § 41-5916, Disclosure Requirements | Specifies the information about external review procedures that health carriers must include in policies, certificates, and other evidences of... |
| Cost reporting by insurance companies (Cross reference Provider Resource Use) | Idaho Admin. Code r. 18.04.04.014, Annual Report to the Director | Requires managed care organizations to annually file a financial report with the Insurance Director. Requires the report to be prepared using... |
| Idaho Code Ann. § 41-3910, Reports to the Director | Requires Managed Care Organizations to file financial reports to the Insurance Director by June 1 of every year. |
| Preexisting condition information: How the insurer may use preexisting condition information | Idaho Admin. Code r. 18.04.10.082, Prohibition Against Use of Genetic Information and Requests for Genetic Testing | Prohibits insurance carriers that issue Medicare supplement coverage from using an individual’s genetic information as the basis to deny or... |
| Required testing by insurance company(genetic and HIV/STD) | Idaho Admin. Code r. 18.04.10.082, Prohibition Against Use of Genetic Information and Requests for Genetic Testing | Prohibits insurance carriers that issue Medicare supplement coverage from using an individual’s genetic information as the basis to deny or... |
| Health plan required reporting | Idaho Code Ann. § 41-5914, External Review Reporting Requirements | Requires independent review organizations to maintain records of requested and assigned external reviews. Specifies the data that such organizations... |
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