The purpose of this Regulation is to implement 18 Del.C. §§ 332, 6408, 6416 and 6417 which require health insurance carriers to establish a procedure for internal review of a carrier's adverse coverage determination and which require the Delaware Insurance Department to establish and administer procedures for independent utilization review upon completion of the carrier's internal review process. This Regulation is promulgated pursuant to 18 Del.C. §§ 311, 332, 6408, 6416, and 6417 and 29 Del.C. Ch. 101. This Regulation should not be construed to create any cause of action not otherwise existing at law.
18 Del. Admin. Code § 1301-1.0
21 DE Reg. 580 (1/1/2018) (Final)