514.21 - UTILIZATION REVIEW PROGRAM.
514.21 UTILIZATION REVIEW PROGRAM. A utilization review program shall be established for purposes of health care cost control, according to usual and customary third-party insurance payment or reimbursement procedures, by a corporation subject to this chapter and by physician providers as defined in section 135.1 and registered nurse providers licensed under chapter 152. This utilization review program shall not be used directly or indirectly to circumvent the provisions for payment or reimbursement to providers of health care services as provided in section 509.3, subsection 1, paragraphs "f" and "g", and section 514.7.
Section History: Recent Form 86 Acts, ch 1180, § 9; 89 Acts, ch 164, § 4 Utilization and cost control; see also chapter 514F