44-5426 Utilization review program; use of clinical review criteria.

NE Code § 44-5426 (2019) (N/A)
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44-5426. Utilization review program; use of clinical review criteria.

A utilization review program shall use documented clinical review criteria that are based on sound clinical evidence and are evaluated periodically to assure ongoing efficacy. A health carrier may develop its own clinical review criteria, or it may purchase or license clinical review criteria from qualified vendors. A health carrier shall make available its clinical review criteria upon request to authorized government agencies.

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