• Date Due: December 01, 2026
  • Author: State Corporation Commission
  • Enabling Authority: Code of Virginia - § 38.2-3445.02 (J.)
  • Description:
    Annual report summarizing the dispute resolution information provided by arbitrators, including information related to the matters decided through arbitration as well as the information provided by health carriers pursuant to subsection I of Code of Virginia § 38.2-3445.02. For each dispute resolved through arbitration, the report shall include the name of the carrier, the name of the health care provider, the name of the filing party, the health care facility where the services were rendered, the type of health care services at issue, and in which party's favor the dispute was resolved. The report shall also include (i) the number and type of claims resolved by arbitration; (ii) aggregate information on the disposition of such arbitrations, including in which party's favor the dispute was resolved; (iii) aggregate information on the variation between the initial payment and final settlement amounts; (iv) the number of health care providers in the health carrier's network of emergency services providers and surgical or ancillary services providers whose participation in the network was terminated by the health carrier or the health care provider in the previous year and whose participation was subsequently reinstated in the same year; and (v) a summary of the nature and extent of differences in payment levels prior to termination and after reinstatement, if applicable, including a determination of whether such payment levels after reinstatement were higher or lower than those applied prior to termination.