65.2-1306 - Corrective action.
§ 65.2-1306. Corrective action.
A. If it is determined that a physician improperly overutilized or otherwiserendered or ordered inappropriate medical treatment or services, or that thecost or duration of such treatment or services was inappropriate, theregional peer review committee shall, in accordance with the standard setforth in § 65.2-605, adjust the amount of reimbursement to which thephysician is entitled pursuant to this title and, if the physician alreadyhas been paid, shall require such physician to repay any excess amount thatwas paid to him for rendering or ordering such treatment or services.
B. Any such determination by any regional peer review committee shall bereviewable by the Commission, which shall have exclusive jurisdiction toeffect any such review. Any review by the Commission shall be pursuant to §65.2-714. To be entitled to review by the Commission, the physician mustdeliver to the Commission written notice of his request for review, whichnotice must be received within thirty days after notice of the decision ofthe regional peer review committee is received by the physician.
C. By accepting payment pursuant to this title, (i) any physician, anyhospital and any employee shall be deemed to have consented to the submittingof all records concerning treatment of the employee to the Commission, to theStatewide Coordinating Committee, to any regional peer review committee, orto any agent of any such committee and (ii) any physician shall be deemed toagree to comply with any decision of the regional peer review committee,subject to his right to have the decision reviewed by the Commission.
(1980, c. 444, § 65.1-159; 1991, c. 355.)