Pennsylvania Statutes Title 40 P.S. Insurance § 991.2164h. Binding nature of external review decision

(a) Binding on insurer.--An external review decision shall be binding on the insurer, except to the extent the insurer has other remedies available under applicable State law.

(b) Binding on covered person.--An external review decision shall be binding on a covered person, except to the extent the covered person has other remedies available under applicable Federal and State law.

(c) Finality of decision.--Neither the covered person nor the covered person's authorized representative may file a subsequent request for external review involving the same adverse benefit determination or final adverse benefit determination for which the covered person has already received an external review decision under this subdivision.