Sec. 18. (a) This chapter does not require a utilization review agent to disclose information that is proprietary.

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Terms Used In Indiana Code 27-8-17-18

  • department: refers to the department of insurance. See Indiana Code 27-8-17-2
  • utilization review: means a system for prospective, concurrent, or retrospective review of the medical necessity and appropriateness of health care services provided or proposed to be provided to a covered individual. See Indiana Code 27-8-17-6
  • utilization review agent: means any entity performing utilization review, except the following:

    Indiana Code 27-8-17-7

     (b) Any:

(1) information concerning standards, criteria, or medical protocols used by a utilization review agent in conducting utilization review; or

(2) other proprietary information concerning utilization review conducted by a utilization review agent;

that is disclosed to the department of insurance under this chapter is confidential for the purposes of IC 5-14-3-4(a)(1) and may not be disclosed by the department.

As added by P.L.128-1992, SEC.1. Amended by P.L.1-1993, SEC.207.

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