November 20, 2016

On Wednesday, November 18, 2015, the federal government published Final Rules addressing the internal claims and appeal processes, along with external review requirements, that were originally established through the Affordable Care Act (ACA).  To find out more, click here.

September 3, 2016

As of July 1, 2015, Wyoming has updated the external review request period. To find out more, click here.

September 3, 2016

On July 1, 2016, Michigan chaptered HB 4933 – 4935 which makes several important changes to the state’s internal grievance and external review processes. The bills have been assigned Public Act No. 276 with immediate effect. The bill will become law on July 13, 2016. H.B. 4933 makes changes to Michigan’s Patient’s Right to Independent […]

February 3, 2016

The Case Management Society of America (CMSA) has included information on RegQuest’s recently published Utilization Management Regulatory & Market Trends: 2016 Annual Report in the February edition of their monthly eNewsletter, CMSA Today. Click here to check it out!

January 3, 2016

Thank you to all who attended our recent webinar titled Analyzing Trends in Utilization Management: A Focus on Regulations! This session reviewed information on the scope, licensure requirements, reviewer qualifications and the ways in which utilization management (UM) services are often integrated into a dynamic “care coordination” approach that may incorporate case management and disease […]