ER Regulations: Key Requirements
October 24, 2019
Does the state have an ER provision? |
Timeframe Standard Appeals |
Timeframe Expedited Appeal |
Timeframe Experimental Appeal |
ACA Compliant? |
|
Alabama |
No | No | |||
Alaska |
Yes | 45 days | 72 hours | 20 days | Yes, NAIC-parallel |
Arizona |
Yes | 21 days (medical necessity);15 days (coverage) | 72 hours (medical necessity); 2 days (coverage) | No provision. | Yes, meets similar |
Arkansas |
Yes | 45 working days | 72 hours | 20 days (standard); 5 days or 48 hours, if not in writing (expedited) | Yes, meets parallel |
California |
Yes | 30 days | 3 days | 7 days (expedited) | Yes, meets parallel |
Colorado |
Yes | 45 calendar days | 72 hours | No provision. | Yes, meets parallel |
Connecticut |
Yes | 45 days | 72 hours; 24 hours (behavioral health) | 20 days (standard); 5 days (expedited) | Yes, meets parallel |
Delaware |
Yes | 45 days | 72 hours | No provision. | Yes, meets similar |
DC |
Yes | 45 calendar days | 72 hours | No provision. | Yes, meets similar |
Florida |
No | No | |||
Georgia |
Yes | 15 working days | 72 hours | 15 working days (standard); 72 hours (expedited) | No |
Guam |
No | No | |||
Hawaii |
Yes | 45 working days | 72 hours | 20 days (standard); 48 hours (expedited) | Yes, meets parallel |
Idaho |
Yes | 42 days | 72 hours | No provision. | Yes, meets parallel |
Illinois |
Yes | 45 days | 72 hours | 20 days (standard); 5 calendar days (expedited) | Yes, meets parallel |
Indiana |
Yes | 15 business days | 72 hours | No provision. | Yes, meets similar |
Iowa |
Yes | 45 days | 72 hours | 20 days | Yes, meets parallel |
Kansas |
Yes | 30 business days | 72 hours | No provision. | Yes, meets parallel |
Kentucky |
Yes | 21 calendar days | 24 hours | 21 calendar days (standard); 24 hours (expedited) | Yes, meets parallel |
Louisiana |
Yes | 45 days | 72 hours | 20 days (standard); 48 hours (expedited) | Yes, meets parallel |
Maine |
Yes | 30 days | 72 hours | No provision. | Yes, meets parallel |
Maryland |
Yes | 45 days | 20 hours | No provision. | Yes, meets parallel |
Massachusetts |
Yes | 45 calendar days | 72 hours | No provision. | Yes, meets parallel |
Michigan |
Yes | 7 days (medical issue); 14 days (coverage) | 24 hours | 7 days (medical issue); 14 days (coverage) | Yes, meets parallel |
Minnesota |
Yes | 45 days | 72 hours | No provision | Yes, meets parallel |
Mississippi |
Yes | 45 days | 72 hours | 20 days | Yes, meets parallel |
Missouri |
Yes | 25 calendar days | 72 hours | No provision. | Yes, meets parallel |
Montana |
Yes | 45 days | 72 hours | 20 days (standard); 48 hours (expedited) | Yes, meets parallel |
Nebraska |
Yes | 45 days | 72 hours | 20 days (standard); 5 calendar days or 48 hours, if not in writing (expedited) | Yes, meets parallel |
Nevada |
Yes | 15 days | 48 hours | 20 days (standard); 5 calendar days (expedited) | Yes, meets parallel |
New Hampshire |
Yes | 20 days | 72 hours | No provision. | Yes, meets parallel |
New Jersey |
Yes | 90 days | No provision. | No provision. | Yes, meets parallel |
New Mexico |
Yes | 20 days | 72 hours or 48 hours, if telephone notification | No provision. | Yes, meets similar |
New York |
Yes | 30 days | 72 hours | 30 days (standard); 72 hours (expedited) | Yes, meets parallel |
North Carolina |
Yes | 45 days | 3 days | 45 days (standard); 3 days (expedited) | Yes, meets parallel |
North Dakota |
Yes | 45 days | 72 hours | No provision. | Yes, meets parallel |
Ohio |
Yes | 30 days | 72 hours | 30 days (standard); 72 hours (expedited) | Yes, meets parallel |
Oklahoma |
Yes | 45 days | 72 hours | No provision. | Yes, meets parallel |
Oregon |
Yes | 30 days | 72 hours | 30 days (standard); 72 hours (expedited) | Yes, meets parallel |
Pennsylvania |
Yes | 60 days | 2 business days | No provision. | No |
Puerto Rico |
Yes | 45 days | 72 hours | 20 days | Yes, meets parallel |
Rhode Island |
Yes | 10 calendar days | 72 hours | 10 calendar days (standard);72 hours (expedited) | Yes; meets parallel |
South Carolina |
Yes | 45 days | 72 hours | No provision. | Yes, meets parallel |
South Dakota |
Yes | 45 days | 72 hours | 20 days (standard); 48 hours (expedited) | Yes, meets parallel |
Tennessee |
Yes | 40 days | 72 hours | 20 days | Yes, meets parallel |
Texas |
Yes | 15-20 days | 3 days | No provision. | Yes, meets similar |
Utah |
Yes | 45 calendar days | 72 hours | 20 calendar days (standard); 48 hours (expedited) | Yes, meets parallel |
Vermont |
Yes | 30 days | 3 days | 30 days (standard); 3 days (expedited) | Yes, meets parallel |
Virgin Islands |
No | No | |||
Virginia |
Yes | 45 working days | 72 hours | 20 days (standard); 7 days (expedited) | Yes, meets parallel |
Washington |
Yes | 15-25 days | 72 hours | 15-25 days (standard); 72 hours (expedited) | Yes, meets parallel |
West Virginia |
Yes | 45 days | 72 hours | 20 days (standard); 48 hours (expedited) | Yes, meets parallel |
Wisconsin |
Yes | 30 business days | 72 hours | 30 days (standard); 72 hours (expedited) | No |
Wyoming |
Yes | 45 days | 72 hours | No provision. | Yes, meets similar |