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Code · Nebraska · Chapter 44 — Insurance

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

63 words·~1 min read·/ne/chapter-44/44-5426

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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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