§ 15-10B-02

The purpose of this subtitle is to:

(1) promote the delivery of quality health care in a cost effective manner that ensures timely access to health care services;

(2) foster greater coordination, communication, and transparency between payors, patients, and providers conducting utilization review activities;

(3) protect patients, business, and providers by ensuring that private review agents are qualified to perform utilization review activities and to make informed decisions on the appropriateness of medical care; and

(4) ensure that private review agents maintain the confidentiality of medical records in accordance with applicable State and federal laws.