Effective – 28 Aug 2019, 2 histories 374.500. Definitions. — As used in sections 374.500 to 374.515, the following terms mean: (1) “Certificate”, a certificate of registration granted by the department of commerce and insurance to a utilization review agent; (2) “Director”, the director of the department of commerce and insurance; (3) “Enrollee”, an individual […]
Effective – 10 Jul 1991 374.503. Certificate required for utilization review agents, exceptions. — 1. A utilization review agent may not conduct utilization review in this state unless the Missouri department of commerce and insurance has granted the utilization review agent a certificate. 2. No certificate is required for those review agents conducting general in-house […]
Effective – 10 Jul 1991 374.505. Application for certificate, content, form, fee. — 1. An applicant for a certificate shall: (1) Submit an application to the department of commerce and insurance; and (2) Pay to the department of commerce and insurance the application fee established by the department through regulation. 2. The application shall: (1) […]
Effective – 28 Aug 1997 374.507. Information may be required by department of commerce and insurance. — In conjunction with the application, the utilization review agent shall submit additional information as required by the department of commerce and insurance. ——– (L. 1991 S.B. 352 § 4, A.L. 1997 H.B. 335)
Effective – 28 Aug 1997 374.510. Minimum requirements for utilization review agents. — 1. All utilization review agents shall meet the minimum requirements set forth in sections 376.1350 to 376.1390. 2. All utilization review agents certified before September 1, 1997, shall meet the requirements set forth in sections 376.1350 to 376.1390 by January 1, 1998, […]
Effective – 28 Aug 2007 374.512. Violation of regulations, notice to agent — powers of director to discipline — penalties. — 1. Whenever the director has reason to believe that a utilization review agent subject to sections 374.500 to 374.515 has been or is engaged in conduct which violates the provisions of sections 374.500 to […]
Effective – 28 Aug 1993 374.515. Rules and regulations authorized. — The director may promulgate such rules and regulations necessary to implement the provisions of sections 374.500 to 374.515, pursuant to the provisions of section 374.045 and chapter 536. ——– (L. 1991 S.B. 352 § 6 subsecs. 4 to 8, A.L. 1993 S.B. 52)
