Insurance Law 4915 — Legislation

Legislation Search OpenLegislation Statutes Search Term Search icon Search previous SECTION 4914 Procedures for external appeals of adverse determinations up TITLE 2 Right to External Appeal next SECTION 4916 Oversight and surveillance of the external appeal process Viewing most recent revision (from 2014-09-22) View historical revision as of: -- Choose a Date -- 2014-09-22 Share Facebook Email SECTION 4915 Prohibited practices Insurance (ISC) CHAPTER 28, ARTICLE 49, TITLE 2 § 4915. Prohibited practices. An external appeal agent shall not, with respect to external appeal activities, permit or provide compensation or anything of value to its employees, agents, or contractors based on: (a) either a percentage of the amount by which a claim is reduced for payment or the number of claims or the cost of services for which the person has denied authorization or payment; or (b) any other method that encourages the upholding of an adverse determination.