§ 27-8-17-14 — Accreditation and approval of review agent; determination; new certificate of registration; order to cease activities

Indiana § 27-8-17-14

• Jurisdiction: Indiana
• Title 27: INSURANCE
• Art. 8: LIFE, ACCIDENT, AND HEALTH
• Ch. 17: Health Care Utilization Review

Text

(a) The department may, according to the
rules adopted under section 20 of this chapter, determine that a
utilization review agent satisfies the requirements set forth in section
11 of this chapter if the utilization review agent:
(1) has, at the time of issuance of the agent's certificate of
registration, received; and
(2) maintains;
the approval or accreditation of a utilization review accreditation
organization that has been approved by the department for the purposes
of this section. The department may not make a determination under
this subsection before July 1, 1993.
(b) If a utilization review agent:
(1) is determined to satisfy the requirements of section 11 of this
chapter by obtaining accreditation from a utilization review
accreditation organization; and
(2) subsequently loses the accreditation from the accrediting
organization;
the utilization review agent must, within sixty (60) days after losing its
accreditation, obtain a new certificate of registration under this chapter
to continue to conduct utilization review in Indiana. During the sixty
(60) day period, the utilization review agent may continue to conduct
utilization review subject to all other requirements of this chapter,
unless ordered to cease under subsection (c).
(c) If the department determines, before the expiration of the sixty
(60) day period referred to in subsection (b), that the utilization review
agent cannot satisfy the requirements for issuance of a certificate of
registration under this chapter, the department shall order the
utilization review agent to immediately cease all utilization review
activities in Indiana.

Legislative History

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