2006 Louisiana Laws - RS 22:2021 — Medical necessity review

§2021.  Medical necessity review

Every health maintenance organization shall assure full compliance with Chapter 7 of this Title in establishing procedures for continuous review of quality of care, performance of providers, utilization of health services, facilities, and costs.  The medical necessity review requirements and administrative treatment guidelines of the health maintenance organization shall not fall below the appropriate standard of care and shall not impinge upon the independent medical judgment of the treating health care provider.  Nothing in this Section shall be construed to prevent a health maintenance organization from conducting a medical necessity review and quality assurance program.

Acts 1986, No. 1065, §1; Acts 1997, No. 238, §1, eff. June 16, 1997; Acts 1997, No. 1324, §1; Acts 1999, No. 401, §1, eff. Jan. 1, 2000.