Utah § 34A-2-407.5 Rules regarding treatment protocols and determinations of medical necessity -- Contracts.

Utah Statutes

§ 34A-2-407.5 — Rules regarding treatment protocols and determinations of medical necessity -- Contracts.

Utah § 34A-2-407.5

Title 34AUtah Labor Code

Ch. 34A-2Workers' Compensation Act

Part 34A-2-4Compensation and Benefits

This text of Utah § 34A-2-407.5 (Rules regarding treatment protocols and determinations of medical necessity -- Contracts.) is published on Counsel Stack Legal Research, covering Utah primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

Utah Code Ann. § 34A-2-407.5 (2026).

Text

(1)The commission may by rule, made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, establish for purposes of health care goods and services compensable under this chapter and Chapter 3, Utah Occupational Disease Act, reasonable health care treatment protocols, that include determinations of medical necessity, and medical treatment and quality care guidelines that are:

(1)(a) scientifically based;

(1)(b) peer reviewed; and

(1)(c) consistent with any general standards for health care treatment protocols that the commission establishes by rule.

(2)Notwithstanding Subsection (1), the commission may authorize an insurer or employer to use all or part of reasonable health care treatment protocols, that include determinations of medical necessity, and medical trea

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(1) The commission may by rule, made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, establish for purposes of health care goods and services compensable under this chapter and Chapter 3, Utah Occupational Disease Act, reasonable health care treatment protocols, that include determinations of medical necessity, and medical treatment and quality care guidelines that are:

(1)(a) scientifically based;
(1)(b) peer reviewed; and
(1)(c) consistent with any general standards for health care treatment protocols that the commission establishes by rule.
(2) Notwithstanding Subsection (1), the commission may authorize an insurer or employer to use all or part of reasonable health care treatment protocols, that include determinations of medical necessity, and medical treatment and quality care guidelines that are:

(2)(a) scientifically based;
(2)(b) peer reviewed; and
(2)(c) consistent with any general standards for health care treatment protocols that the commission shall establish by rule.
(3) Nothing in this section shall be construed to prevent:

(3)(a) an insurer or employer from contracting with a provider of health services as permitted by Subsection 34A-2-111(2)(c)(i)(B)(VII);
(3)(b) the commission from adjudicating disputes arising under the terms of this section; or
(3)(c) a provider of health services from bringing to the commission a dispute arising under protocols, guidelines, or other terms of this section.