Missouri Laws 374.503 – Certificate required for utilization review agents, exceptions
Current as of: 2024 | Check for updates
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1. A utilization review agent may not conduct utilization review in this state unless the Missouri department of commerce and insurance has granted the utilization review agent a certificate.
2. No certificate is required for those review agents conducting general in-house utilization review for hospitals, home health agencies, clinics, private offices or any other health facility or entity, so long as the review does not result in the approval or denial of payment for hospital or medical services for a particular case.
Terms Used In Missouri Laws 374.503
- Department: the department of commerce and insurance. See Missouri Laws 374.005
- State: when applied to any of the United States, includes the District of Columbia and the territories, and the words "United States" includes such district and territories. See Missouri Laws 1.020