Nebraska Statutes 44-5426. Utilization review program; use of clinical review criteria
Current as of: 2023 | Check for updates
|
Other versions
A utilization review program shall use documented clinical review criteria that are based on sound clinical evidence and are evaluated periodically to assure ongoing efficacy. A health carrier may develop its own clinical review criteria, or it may purchase or license clinical review criteria from qualified vendors. A health carrier shall make available its clinical review criteria upon request to authorized government agencies.
Source
Terms Used In Nebraska Statutes 44-5426
- Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.