376.1359. Written utilization program implemented, filed with the director.
Written utilization program implemented, filed with the director.
376.1359. 1. A health carrier that conducts utilization review shallimplement a written utilization review program that describes all reviewactivities, both delegated and nondelegated, for covered services provided.The program document shall describe information as required by thedirector.
2. A health carrier shall file an annual report of its utilizationreview program activities with the director.
(L. 1997 H.B. 335)