26.1-26.4-01. Purpose and scope

26.1-26.4-01. Purpose and scope This chapter applies to grandfathered health plans unless a health care insurer or utilization review agent determines to extend the protections of section 26.1-36-47 to a grandfathered plan. "Grandfathered health plan" has the meaning stated in the Patient Protection and Affordable Care Act [Pub. L. 111-148], as amended by the Health Care and Education Reconciliation Act of 2010 [Pub. L. 111-152]. The purpose of this chapter is to: 1. Promote the delivery of quality health care in a cost-effective manner; 2. Assure that utilization review agents adhere to reasonable standards for conducting utilization review; 3. Foster greater coordination and cooperation between health care providers and utilization review agents; 4. Improve communications and knowledge of benefits among all parties concerned before expenses are incurred; and 5. Ensure that utilization review agents maintain the confidentiality of medical records in accordance with applicable laws.