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§4915 . Prohibited practices. An external appeal agent shall not, with respect to external appeal activities, permit or provide compensation or anything of value to its employees, agents, or contractors based on:
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(a) either a percentage of the amount by which a claim is reduced for payment or the number of claims or the cost of services for which the person has denied authorization or payment; or
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(b) any other method that encourages the upholding of an adverse determination. Source Data downloaded: 2009-04-10 09: 17: 48; Processed: 2009-05-08 15: 36: 16 |
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