2005 North Carolina Code - General Statutes § 58-50-85. Approval of independent review organizations.

§ 58‑50‑85.  Approval of independent review organizations.

(a)       The Commissioner shall approve independent review organizations eligible to be assigned to conduct external reviews under this Part to ensure that an organization satisfies the minimum qualifications established under G.S. 58‑50‑87. The Commissioner shall develop an application form for initially approving and for reapproving organizations to conduct external reviews.

(b)       Any organization wishing to be approved to conduct external reviews under this Part shall submit the application form and include with the form all documentation and information necessary for the Commissioner to determine if the organization satisfies the minimum qualifications established under G.S. 58‑50‑87. Applicants must submit pricing information sufficient to demonstrate that if selected, the applicant's total fee per review will not exceed commercially reasonable fees charged for similar services in the industry. The Commissioner shall not approve any independent review organization that either fails to provide sufficient pricing information or has fees that do not meet the guidelines established under this subsection.

(c)       The Commissioner may determine that accreditation by a nationally recognized private accrediting entity with established and maintained standards for independent review organizations that meet the minimum qualifications established under G.S. 58‑50‑87 will cause an independent review organization to be deemed to have met, in whole or in part, the requirements of this section and G.S. 58‑50‑87. A decision by the Commissioner to recognize an accreditation program for the purpose of granting deemed status may be made only after reviewing the accreditation standards and program information submitted by the accrediting body. An independent review organization seeking deemed status due to its accreditation shall submit original documentation issued by the accrediting body to demonstrate its accreditation.

(d)       An approval is effective for two years, unless the Commissioner determines before expiration of the approval that the independent review organization is not satisfying the minimum qualifications established under G.S. 58‑50‑87.

(e)       Whenever the Commissioner determines that an independent review organization no longer satisfies the minimum requirements established under G.S. 58‑50‑87, the Commissioner shall terminate the approval of the independent review organization. (2001‑446, s. 4.5.)