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Ind. Code § 27-1-37.5-1.8

"Clinical criteria"

As added by P.L.144-2025, SEC.6.

Sec. 1.8. As used in this chapter, "clinical criteria" means:

(1) written policies;

(2) written screen procedures;

(3) drug formularies or lists of covered drugs;

(4) determination rules;

(5) determination abstracts;

(6) clinical protocols;

(7) practice guidelines;

(8) medical protocols; and

(9) any other criteria or rationale;

used by the utilization review entity to determine the medical necessity of a health care service.

Official source: Indiana General Assembly. Reproduced from public-domain Indiana statutes; confirm against the official source for the current text. Not legal advice.