Section R590-194-4 - Minimum Standards and General Provisions(1) Preauthorization for dietary products may be required if it is stated in the policy.(2) Each insurer shall provide direct access to a designated person familiar with dietary products to facilitate the processing of claims.(3) Dietary products shall be paid under the major medical benefit as any other illness and not under any limited benefit, such as durable medical equipment (DME).(4) An insurer may request additional information required to determine the eligibility of the claim under the terms of the policy.(5)(a) "Coverage for Metabolic Dietary Products Standard version 2.1," adopted by the Utah Health Information Network (UHIN), is incorporated by reference and is available on the department's website, https://insurance.utah.gov.(b) This uniform billing standard shall be utilized for billing and processing claims for dietary products.Utah Admin. Code R590-194-4
Amended by Utah State Bulletin Number 2023-02, effective 1/10/2023