Missouri Code of State Regulations
Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE
Division 400 - Life, Annuities and Health
Chapter 10 - Health Carrier Utilization Review Activities
Section 20 CSR 400-10.250 - Electronic Confirmation of Utilization Review Determinations Deemed Made When
Current through Register Vol. 49, No. 24, December 16, 2024
PURPOSE: This rule describes the conditions under which an electronic notice of a utilization review determination will be deemed to have been made.
(1) When a health carrier is required by section 376.1363, RSMo, H.B. 335 (First Regular Session of the 89th General Assembly 1997), to provide written or electronic confirmation of its utilization review determinations to providers, enrollees or certificate holders (enrollees and certificate holders hereinafter collectively referred to as enrollees), for plans containing a managed care component, an electronic confirmation will be deemed by the department to have been made if the confirmation is available to the provider and enrollee on an interactive voice response telephone system or other electronic notification system which is universally accessible and compatible with the Telecommunication Device for the Deaf, if-
*Original authority: 374.045, RSMo 1967, amended 1993, 1995.