420-J:1 Purpose and Intent
420-J:2 Applicability and Scope
420-J:3 Definitions
420-J:3-a Access to Enhanced 911 System
420-J:3-b Pre-certification Requirement
420-J:4 Credentialing Verification Procedures
420-J:4-a Facility Credentialing
420-J:5 Grievance Procedures
420-J:5-a Right to External Review
420-J:5-b Standard External Review
420-J:5-c Expedited External Review
420-J:5-d Certification of Independent Review Organizations
420-J:5-e General Provisions Regarding External Review
420-J:6 Utilization Review
420-J:6-a Obstetrical-Gynecological Coverage
420-J:6-b Self-Referrals for Chiropractic Care
420-J:6-c Third-Party Payment of Covered, Court-Ordered Services
420-J:6-d Coverage for Dependents
420-J:6-e Coverage for Medically Necessary Dental Services
420-J:7 Network Adequacy
420-J:7-b Prescription Drugs
420-J:7-c Disqualification of Certain Physicians Prohibited
420-J:7-d Continued Access to Care Subsequent to a Provider Contract Termination
420-J:7-e Notice of Consumer Rights
420-J:8 Provider Contract Standards
420-J:8-a Prompt Payment Required
420-J:8-b Retroactive Denials Prohibited; Exceptions
420-J:8-c Reimbursement for Providers Waiting for Health Carrier Credentialing Verification
420-J:8-d Dependent Coverage
420-J:8-e Reasonable Value of Health Care Services
420-J:8-f Non-Covered Dental Services
420-J:9 Quality Assessment, Quality Improvement, and Reporting
420-J:10 Confidentiality of Insurer Records
420-J:11 Confidentiality of Insurance Department Records
420-J:12 Rulemaking Authority
420-J:13 Severability
420-J:14 Penalties
420-J:15 Definitions
420-J:16 Levels of Care Criteria; Attestation
420-J:17 Prior Authorization
420-J:18 Authorization for Medication-Assisted Treatment
420-J:19 Medication Synchronization

Terms Used In New Hampshire Revised Statutes > Chapter 420-J - Managed Care Law

  • Allegation: something that someone says happened.
  • 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.
  • Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
  • 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
  • biennially: when applied to meetings and elections in towns, shall mean the biennial meetings and elections required by law to be holden in the month of November biennially, dating from the commencement of biennial elections in 1878; and the word "annual" when applied to meetings and elections in towns, shall mean the annual meetings and elections required by law to be holden in the month of March. See New Hampshire Revised Statutes 21:7
  • Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
  • 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.
  • Dependent: A person dependent for support upon another.
  • Discovery: Lawyers' examination, before trial, of facts and documents in possession of the opponents to help the lawyers prepare for trial.
  • Entitlement: A Federal program or provision of law that requires payments to any person or unit of government that meets the eligibility criteria established by law. Entitlements constitute a binding obligation on the part of the Federal Government, and eligible recipients have legal recourse if the obligation is not fulfilled. Social Security and veterans' compensation and pensions are examples of entitlement programs.
  • 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.
  • following: when used by way of reference to any section of these laws, shall mean the section next preceding or following that in which such reference is made, unless some other is expressly designated. See New Hampshire Revised Statutes 21:13
  • Fraud: Intentional deception resulting in injury to another.
  • 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.
  • Litigation: A case, controversy, or lawsuit. Participants (plaintiffs and defendants) in lawsuits are called litigants.
  • month: shall mean a calendar month, and the word "year" a calendar year, unless otherwise expressed; and the word "year" shall be equivalent to the expression "year of our Lord. See New Hampshire Revised Statutes 21:8
  • Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses.
  • person: may extend and be applied to bodies corporate and politic as well as to individuals. See New Hampshire Revised Statutes 21:9
  • petition: when used in connection with the equity jurisdiction of the superior court, and referring to a document filed with the court, shall mean complaint, and "petitioner" shall mean plaintiff. See New Hampshire Revised Statutes 21:51
  • Recourse: An arrangement in which a bank retains, in form or in substance, any credit risk directly or indirectly associated with an asset it has sold (in accordance with generally accepted accounting principles) that exceeds a pro rata share of the bank's claim on the asset. If a bank has no claim on an asset it has sold, then the retention of any credit risk is recourse. Source: FDIC
  • Settlement: Parties to a lawsuit resolve their difference without having a trial. Settlements often involve the payment of compensation by one party in satisfaction of the other party's claims.
  • state: when applied to different parts of the United States, may extend to and include the District of Columbia and the several territories, so called; and the words "United States" shall include said district and territories. See New Hampshire Revised Statutes 21:4
  • Statute: A law passed by a legislature.
  • Statute of limitations: A law that sets the time within which parties must take action to enforce their rights.
  • Subpoena: A command to a witness to appear and give testimony.
  • Testimony: Evidence presented orally by witnesses during trials or before grand juries.
  • United States: shall include said district and territories. See New Hampshire Revised Statutes 21:4
  • Uphold: The decision of an appellate court not to reverse a lower court decision.