P.R. Laws tit. 26, § 9511
(a) An external review decision is binding on the health insurance organization or issuer except to the extent the health insurance organization or issuer has other remedies available under the applicable laws of Puerto Rico.
(b) An external review decision is binding on the covered person or enrollee, except to the extent the covered person or enrollee has other remedies available under the applicable laws of Puerto Rico or federal law.
(c) A covered person or enrollee may not file a subsequent request for external review involving the same adverse determination or final adverse determination for which the covered person has already received an external review decision pursuant to this chapter.
History —Aug. 29, 2011, No. 194, added as § 28.110 on Aug. 23, 2012, No. 203, § 7, eff. 90 days after Aug. 23, 2012.