514.21 Utilization review program.
A utilization review program shall be established for purposes of health care cost control, according to usual and customary third-party insurance payment or reimbursement procedures, by a corporation subject to this chapter and by physician providers as defined in section 135.1 and registered nurse providers licensed under chapter 152. This utilization review program shall not be used directly or indirectly to circumvent the provisions for payment or reimbursement to providers of health care services as provided in section 509.3, subsection 1, paragraphs “f” and “g”, and section 514.7.
86 Acts, ch 1180, §9; 89 Acts, ch 164, §4
Utilization and cost control; see also chapter 514F
Structure Iowa Code
Chapter 514 - NONPROFIT HEALTH SERVICE CORPORATIONS
Section 514.1 - Applicability — definitions.
Section 514.2 - Incorporation.
Section 514.2A - Service of process.
Section 514.3 - Approval by commissioner.
Section 514.5 - Contracts for service.
Section 514.6 - Rates — approval by commissioner.
Section 514.7 - Contracts — approval by commissioner — provisions to be available.
Section 514.8 - Contracts with providers — approval.
Section 514.9 - Annual report.
Section 514.9A - Certificate of authority — renewal.
Section 514.11 - Costs approved.
Section 514.12 - Investment of funds.
Section 514.13 - Arbitration of disputes.
Section 514.14 - Dissolution or merger.
Section 514.15 - Nonexempt from taxation.
Section 514.16 - Governmental employees included.
Section 514.17 - Physicians and surgeons, podiatric physicians, or dentists — number required.
Section 514.18 - Podiatric physicians.
Section 514.19 - Combined service corporations.