AB518-ASA1-AA21,1,11
5"
(4) The requirement under this section to establish and use an internal
6grievance procedure does not apply to an insurer issuing a health benefit plan that
7is not a limited service health organization, as defined in s. 609.01 (3), a preferred
8provider plan, as defined in s. 609.01 (4), or a managed care plan, as defined in s.
9609.01 (3c), except with respect to treatment, or payment for treatment, that was
10reduced, denied or terminated by the insurer on the basis that the treatment did not
11meet the health benefit plan's requirements for medical necessity.".
AB518-ASA1-AA21,2,2
1"3. The insurer does not offer an internal grievance procedure under s. 632.83
2because of the exception under s. 632.83 (4).".
