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Code · Montana · Title 33 — Insurance and Insurance Companies · Chapter 32 · Part 1

33-32-101. Purpose.

164 words·~1 min read·/mt/title-33/chapter-32/part-1/33-32-101

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33-32-101 . Purpose. The legislature finds and declares that it is the purpose of this chapter to:
(1)promote the delivery of quality health care in a cost-effective manner;
(2)foster greater coordination between health care providers, third-party payors, and others who conduct utilization review activities;
(3)ensure timely access to health care services;
(4)preserve the integrity of the health care provider and patient relationship;
(5)protect patients, employers, and health care providers by:
(a)ensuring that utilization review activities result in informed decisions on the appropriateness of medical care made by those best qualified to be involved in the utilization review process; and
(b)establishing the use of written clinical criteria for utilization review programs and reviews by appropriate health care providers to ensure a fair and transparent process for patients; and
(6)establish written standards and clinical criteria for the structure and operation of utilization review and benefit determination processes designed to facilitate ongoing assessment and management of health care services.
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