Alaska Administrative Code
Title 12 - Professional Regulations
Part 1 - Boards and Commissions Subject to Centralized Licensing
Chapter 16 - Board of Chiropractic Examiners
Article 4 - Utilization Review
12 AAC 16.420 - Conduct of utilization review

(a) A patient, patient's representative, insurer, or the patient's chiropractic physician may file a request for utilization review with the board by submitting to the department

(b) A licensee's acceptance of or request for payment for treatment given to a patient constitutes the licensee's consent to submit to the utilization review committee the information required in (c) of this section.

(c) A licensee involved in a case submitted to the utilization review committee shall submit to the peer review committee all necessary records and other information concerning the patient's treatment.

(d) The utilization review committee shall conduct a utilization review for each request for peer review submitted to it in accordance with guidelines established by the board. Except as provided in (f) of this section, the utilization review committee shall report its findings to the board and furnish a copy of its findings to the patient, licensee, and third-party payor involved in the case.

(e) The findings of the utilization review committee must include a determination of whether the

(f) If the utilization review committee determines that reasonable cause exists to believe the licensee has violated a provision of AS 08.20 or this chapter for which a licensee may be disciplined, the utilization review committee may not report its finding to the board, but instead shall refer the matter to the department's investigative section. The utilization review committee shall provide all information gathered in connection with the utilization review to the department's investigative section.

(g) Repealed 1/6/2002.