Sec. 1272.060. UTILIZATION REVIEW. A delegation agreement required by Section 1272.052 must provide that: (1) enrollees shall receive notification at the time of enrollment of which entity is responsible for performing utilization review; (2) the delegated entity or third party performing utilization review shall perform that review in accordance with Chapter 4201 ; and (3) the delegated entity or third party shall forward utilization review decisions made by the entity or third party to the health maintenance organization on a monthly basis.
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