§ 44-1301 Act, how cited
§ 44-1302 Purpose of act
§ 44-1303 Terms, defined
§ 44-1304 Applicability of act
§ 44-1305 Health carrier; covered person; notification; when; written notice; contents; health carrier; duties
§ 44-1306 Request for external review
§ 44-1307 Request for external review; exhaustion of internal grievance process; request for expedited external review of adverse determination; independent review organization; duties
§ 44-1308 Request for external review; filing;director; duties; health carrier; duties; preliminary review; contents; director;powers; notice of initial determination; contents; independent review organization;powers; duties; decision; notice; contents
§ 44-1309 Request for expedited external review;director; duties; health carrier; duties; notice of initial determination;contents; expedited external review; independent review organization; powers;duties; decision; notice; contents
§ 44-1310 Review of denial of coverage forservice or coverage determined experimental or investigational; external review;expedited external review; director; duties; health carrier; duties; noticeof initial determination; contents; appeal; clinical reviewer; dutie
§ 44-1311 External review decision; how treated;limitation on subsequent request
§ 44-1312 Independent review organizations;approval; qualifications; application; contents; fee; termination of approval;director; powers and duties
§ 44-1313 Independent review organization;minimum qualifications; clinical reviewers; qualifications; limitation onownership or control; conflict of interests; presumption of compliance; director;powers; duties
§ 44-1314 Liability for damages
§ 44-1315 Records; report; contents
§ 44-1316 Health carrier; cost
§ 44-1317 Health carrier; disclosure; format;contents
§ 44-1318 Applicability of act

Terms Used In Nebraska Statutes > Health Carrier External Review Act

  • Action: shall include any proceeding in any court of this state. See Nebraska Statutes 49-801
  • Amendment: A proposal to alter the text of a pending bill or other measure by striking out some of it, by inserting new language, or both. Before an amendment becomes part of the measure, thelegislature must agree to it.
  • Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
  • Attachment: A procedure by which a person's property is seized to pay judgments levied by the court.
  • Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. Source: OCC
  • Codicil: An addition, change, or supplement to a will executed with the same formalities required for the will itself.
  • Company: shall include any corporation, partnership, limited liability company, joint-stock company, joint venture, or association. See Nebraska Statutes 49-801
  • Contract: A legal written agreement that becomes binding when signed.
  • Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
  • Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
  • Decedent: A deceased person.
  • Department: shall mean the Department of Insurance. See Nebraska Statutes 44-103
  • Director: shall mean the Director of Insurance. See Nebraska Statutes 44-103
  • Equitable: Pertaining to civil suits in "equity" rather than in "law." In English legal history, the courts of "law" could order the payment of damages and could afford no other remedy. See damages. A separate court of "equity" could order someone to do something or to cease to do something. See, e.g., injunction. In American jurisprudence, the federal courts have both legal and equitable power, but the distinction is still an important one. For example, a trial by jury is normally available in "law" cases but not in "equity" cases. Source: U.S. Courts
  • Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
  • Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
  • Irrevocable trust: A trust arrangement that cannot be revoked, rescinded, or repealed by the grantor.
  • Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
  • Liabilities: The aggregate of all debts and other legal obligations of a particular person or legal entity.
  • Person: shall include bodies politic and corporate, societies, communities, the public generally, individuals, partnerships, limited liability companies, joint-stock companies, and associations. See Nebraska Statutes 49-801
  • Person shall: include bodies politic and corporate, societies, communities, the public generally, individuals, partnerships, limited liability companies, joint-stock companies, and associations. See Nebraska Statutes 49-801
  • Personal property: All property that is not real property.
  • Power of attorney: A written instrument which authorizes one person to act as another's agent or attorney. The power of attorney may be for a definite, specific act, or it may be general in nature. The terms of the written power of attorney may specify when it will expire. If not, the power of attorney usually expires when the person granting it dies. Source: OCC
  • Probate: Proving a will
  • Process: shall mean a summons, subpoena, or notice to appear issued out of a court in the course of judicial proceedings. See Nebraska Statutes 49-801
  • Revocable trust: A trust agreement that can be canceled, rescinded, revoked, or repealed by the grantor (person who establishes the trust).
  • State: when applied to different states of the United States shall be construed to extend to and include the District of Columbia and the several territories organized by Congress. See Nebraska Statutes 49-801
  • Statute: A law passed by a legislature.
  • Trial: A hearing that takes place when the defendant pleads "not guilty" and witnesses are required to come to court to give evidence.
  • Trustee: A person or institution holding and administering property in trust.
  • United States: shall include territories, outlying possessions, and the District of Columbia. See Nebraska Statutes 49-801
  • Uphold: The decision of an appellate court not to reverse a lower court decision.
  • Year: shall mean calendar year. See Nebraska Statutes 49-801