Subpart P - UTILIZATION REVIEW STANDARDS
- Section 22:1260.41 - Definitions
- Section 22:1260.42 - Documented prior authorization program; requirements
- Section 22:1260.43 - Single utilization review per episode of care
- Section 22:1260.44 - Timeframes for determinations; concurrent review; retrospective review; adverse determination
- Section 22:1260.45 - Documentation
- Section 22:1260.46 - Utilization review; determinations; appeals
- Section 22:1260.47 - Prior authorization; denial of claims
- Section 22:1260.48 - Reviews for fraud, waste, or abuse