Pennsylvania Pennsylvania 2018 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 exemptions are […]

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