§ 24-A §2847 — Utilization review data

1.
Report required.
On or before April 1st of each year, any insurer or 3rd-party administrator which issues or administers a program or contract in this State providing coverage for hospital care that contains a provision whereby in nonemergency cases the insured is required to be prospectively evaluated through a prehospital admission certification, preinpatient service eligibility program or any similar preutilization review or screening eligibility program or any similar preutilization review or screening procedure prior to the delivery of contemplated hospitalization, inpatient or outpatient health care or medical services which are prescribed or ordered by a duly licensed physician shall file a report on the results of that evaluation for the preceding year with the superintendent which shall contain the following:
2.
Residents.
This section is applicable to evaluations, appeals and complaints relating to residents of this State only.
3.
Confidentiality.
Any information provided pursuant to this section shall not identify the patients.

Legislative History

PL 1989, c. 556, §C3 (NEW).