Certificate requirement for utilization review; nontransferability; disclosure to public

1. Law
2. Mississippi Code
3. Public Health
4. Utilization Review of Availability of Hospital Resources and Medical Services
5. Certificate requirement for utilization review; nontransferability; disclosure to public

1. A private review agent who approves or denies payment or who recommends approval or denial of payment for hospital or medical services or whose review results in approval or denial of payment for hospital or medical services on a case by case basis, may not conduct utilization review in this state unless the Mississippi State Department of Health has granted the private review agent a certificate.
2. The Mississippi State Department of Health shall issue a certificate to an applicant that has met all the requirements of this chapter and all applicable regulations of the department.
3. A certificate issued under this chapter is not transferable.
4. The State Department of Health shall adopt regulations to implement the provisions of this chapter. Any information required by the department with respect to customers or patients shall be held in confidence and not disclosed to the public.

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