# 50 Ill. Adm. Code 4530.50: Section 4530.50 Independent Review Organization Obligations

> Illinois · Regulations · In force

URL: https://www.frixlaw.com/law-library/statutes/STATE_IL_IAC_T50_P4530_S4530_50

## Section

- **Citation:** 50 Ill. Adm. Code 4530.50
- **Heading:** Section 4530.50 Independent Review Organization Obligations
- **Jurisdiction:** Illinois
- **Kind:** Regulations
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** Illinois Administrative Code / Title 50 INSURANCE / CHAPTER I: DEPARTMENT OF INSURANCE / Part 4530 HEALTH CARRIER EXTERNAL REVIEW / Section 4530.50 Independent Review Organization Obligations

## Text

Section 4530.50  Independent Review Organization
Obligations
a)         An
independent review organization may not conduct external independent reviews of
adverse determinations for persons subject to Section 15 of the Act unless the
independent review organization has first registered with the Director. An
application for registration shall be in the format set forth in Appendix C.
b)         An
independent review organization must secure and maintain a current certificate
of accreditation by the American Accreditation Healthcare Commission (URAC)
under applicable standards for Independent Review Organizations.
c)         Each
independent review organization shall provide a written notice as set forth in
Appendix A and Appendix B, explaining its decision to uphold or reverse adverse
or final adverse determinations to the health carrier, the covered person, and,
if applicable, the covered person's authorized representative.
d)         Each
independent review organization shall maintain written records in the
aggregate, by state, and by health carrier on all requests for external review
for which it conducted an external review during a calendar year and submit,
electronically, a report in the format specified by the Director by March 1 of
each year. The independent review organization shall retain the written records
required under the Act for at least three years.

## Nearby sections

- [50 Ill. Adm. Code 4530.10 Section 4530.10  Purpose](https://www.frixlaw.com/law-library/statutes/STATE_IL_IAC_T50_P4530_S4530_10.md)
- [50 Ill. Adm. Code 4530.20 Section 4530.20  Applicability and Scope](https://www.frixlaw.com/law-library/statutes/STATE_IL_IAC_T50_P4530_S4530_20.md)
- [50 Ill. Adm. Code 4530.30 Section 4530.30  Definitions](https://www.frixlaw.com/law-library/statutes/STATE_IL_IAC_T50_P4530_S4530_30.md)
- [50 Ill. Adm. Code 4530.40 Section 4530.40  Health Carrier Obligations](https://www.frixlaw.com/law-library/statutes/STATE_IL_IAC_T50_P4530_S4530_40.md)
- [50 Ill. Adm. Code 4530.50 Section 4530.50  Independent Review Organization Obligations](https://www.frixlaw.com/law-library/statutes/STATE_IL_IAC_T50_P4530_S4530_50.md)
- [50 Ill. Adm. Code 4530.60 Section 4530.60  Registration of Independent Review Organizations](https://www.frixlaw.com/law-library/statutes/STATE_IL_IAC_T50_P4530_S4530_60.md)
- [50 Ill. Adm. Code 4530.70 Section 4530.70  Operational Requirements](https://www.frixlaw.com/law-library/statutes/STATE_IL_IAC_T50_P4530_S4530_70.md)
- [50 Ill. Adm. Code 4530.80 Section 4530.80  Examination](https://www.frixlaw.com/law-library/statutes/STATE_IL_IAC_T50_P4530_S4530_80.md)
- [50 Ill. Adm. Code 4530.90 Section 4530.90  Random Selection of IROs by Director](https://www.frixlaw.com/law-library/statutes/STATE_IL_IAC_T50_P4530_S4530_90.md)
- [50 Ill. Adm. Code 4530.APPENDIX Section 4530.APPENDIX  D   Independent Review Organizations – Application for Reapproving Independent Review Organizations](https://www.frixlaw.com/law-library/statutes/STATE_IL_IAC_T50_P4530_S4530_APPENDIX.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_IL_IAC_T50_P4530_S4530_50. Check the current official text before relying on it. Not legal advice.