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Ind. Code § 27-8-17-8

"Utilization review determination" defined

As added by P.L.128-1992, SEC.1.

Sec. 8. (a) As used in this chapter, "utilization review determination" means the rendering of a decision based on utilization review that denies or affirms either of the following:

(1) The necessity or appropriateness of the allocation of resources.

(2) The provision or proposed provision of health care services to a covered individual.

(b) The term does not include the identification of alternative, optional medical care that:

(1) requires the approval of the covered individual; and

(2) does not affect coverage or benefits if rejected by the covered individual.

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