§ 20-9-911 — Revocation or denial of certificate

(a) The State Board of Health may revoke or deny a certificate if the holder does not comply with performance assurances under this section, violates any provision of this subchapter, or violates any rule adopted pursuant to this subchapter. (b) The board shall deny a certificate to any applicant if upon review of the application the board finds that the applicant proposing to conduct a utilization review does not: (1) Have available the services of a sufficient number of qualified medical professionals supported and supervised by appropriate physicians to carry out its utilization review activities; (2) Meet any applicable rules the board adopted under this subchapter relating to the qualifications of private review agents or the performance of utilization review; and (3) Provide assurances satisfactory to the board that: (A) The procedure and policies of the private review agent will protect the confidentiality of medical records; and (B) The review agent will be reasonably accessible to patients and providers for five (5) working days a week during normal business hours in this state.

Legislative History

Amended by Act 2019, No. 315,§ 1856, eff. 7/24/2019. Amended by Act 2019, No. 315,§ 1855, eff. 7/24/2019. Acts 1989, No. 537, § 8.