§ 20-9-904 - When certificate not required.
20-9-904. When certificate not required.
(a) The State Board of Health may waive the requirements of this subchapter for the activities of a private review agent in connection with a contract with the federal government for utilization review of patients eligible for hospital and medical services under the Social Security Act.
(b) No certificate is required for those private review agents conducting general in-house utilization review for hospitals, home health agencies, preferred provider organizations, other managed care entities, clinics, private offices, or any other health facilities or entities, so long as the review does not result in the approval or denial of payment for hospital or medical services for a particular case. The general in-house utilization review is exempt from this subchapter.
(c) No certificate is required for utilization review by any Arkansas-licensed pharmacist or pharmacy, or organizations of either, while engaged in the practice of pharmacy, including, but not limited to, dispensing of drugs, participation in drug utilization reviews, and monitoring patient drug therapy.