374.503. Certificate required for utilization review agents, exceptions. - Missouri Statutes

Certificate required for utilization review agents, exceptions.

374.503. 1. A utilization review agent may not conduct utilizationreview in this state unless the Missouri department of insurance, financialinstitutions and professional registration has granted the utilization reviewagent a certificate.

2. No certificate is required for those review agents conducting generalin-house utilization review for hospitals, home health agencies, clinics,private offices or any other health facility or entity, so long as the reviewdoes not result in the approval or denial of payment for hospital or medicalservices for a particular case.

(L. 1991 S.B. 352 § 2)

Effective 7-10-91