External Reviews - Independent Review Organizations

Article 19 of Chapter 71, Title 38 of the South Carolina Code of Laws is the Health Carrier External Review Act.

These requirements were updated by SCDOI Bulletin 2011-04 to comply with external review requirements of the Patient Protection and Affordable Care Act.

Pursuant to SC Code Section 38-71-2000, the SCDOI approves Independent Review Organizations (IROs) that will be eligible to be assigned to conduct external reviews. Companies seeking approval as an IRO must complete the application provided in SCDOI Bulletin 2001-03.

IRO Applications should be submitted as follows:
1. submit one complete, electronic copy via email to mbailes@doi.sc.gov; and
2. submit one complete, paper copy by mail to
South Carolina Department of Insurance
Attn: Michael Bailes, Market Regulation Coordinator
1201 Main Street, Suite 1000
Columbia, South Carolina 29201

Questions regarding this process should be emailed to mbailes@doi.sc.gov. 

Additional information for health insurance issuers and IROs relating to external reviews is provided in SCDOI Bulletin 2001-04a.