HEALTH CARE UTILIZATION REVIEW
- Section 376.1350. Definitions. (8/28/2018)
- Section 376.1353. Utilization review activities monitored. (8/28/1997)
- Section 376.1356. Utilization review organization monitored, when. (8/28/1997)
- Section 376.1359. Written utilization program implemented, filed with the director. (8/28/1997)
- Section 376.1361. Documented clinical review criteria used in a utilization program — medical director qualifications — compensation of utilization review services. (8/28/1997)
- Section 376.1363. Utilization review decisions, procedures. (8/28/2014)
- Section 376.1365. Reconsideration of an adverse determination, when. (8/28/1997)
- Section 376.1367. Emergency services benefit determination, coverage required, when. (8/28/2018)
- Section 376.1369. Certification of compliance, when. (8/28/1997)
- Section 376.1372. Certification and member handbook to include utilization review procedures. (8/28/1997)
- Section 376.1375. Registry of grievances maintained, procedures — definitions. (8/28/1997)
- Section 376.1378. Grievances and certificate of compliance filed with the director, when. (8/28/1997)
- Section 376.1382. First- and second-level grievance review for managed care plans, first-level procedures. (8/28/1997)
- Section 376.1385. Second-level review procedures. (8/28/1997)
- Section 376.1387. Appeals of grievances determined by the director. (8/28/1997)
- Section 376.1389. Expedited grievance review procedure. (8/28/1997)