Chapter ISC: Insurance
(!4913) Conflict of interest.
(a) No external appeal agent or officer, director, or management employee thereof; or clinical peer reviewer employed or engaged thereby to conduct any external appeal pursuant to this title , shall have any material professional affiliation, material familial affiliation, material financial affiliation, or other affiliation prescribed pursuant to regulation, with any of the following:
(1) the health care plan;
(2) any officer, director, or management employee of the health care plan;
(3) any health care provider, physician's medical group, independent practice association, or provider of pharmaceutical products or services or durable medical equipment, proposing to provide or supply the health service;
(4) the facility at which the health service would be provided;
(5) the developer or manufacturer of the principal health service which is the subject of the appeal; or
(6) the insured whose health care service is the subject of the appeal, or the insured's designee.
(b) Notwithstanding subsection (a) of this section , the superintendent shall promulgate regulations to minimize any conflict of interest where such conflict may be unavoidable.