§ 4913. Conflict of interest. (a) No external appeal agent or officer,
director, or management employee thereof; or clinical peer reviewer
employed or engaged thereby to conduct any external appeal pursuant to
this title, shall have any material professional affiliation, material
familial affiliation, material financial affiliation, or other
affiliation prescribed pursuant to regulation, with any of the
following:

(1) the health care plan;

(2) any officer, director, or management employee of the health care
plan;

(3) any health care provider, physician's medical group, independent
practice association, or provider of pharmaceutical products or services
or durable medical equipment, proposing to provide or supply the health
service;

(4) the facility at which the health service would be provided;

(5) the developer or manufacturer of the principal health service
which is the subject of the appeal; or

(6) the insured whose health care service is the subject of the
appeal, or the insured's designee.

(b) Notwithstanding subsection (a) of this section, the superintendent
shall promulgate regulations to minimize any conflict of interest where
such conflict may be unavoidable.