376.1372. 1. In the certificate of coverage and the member handbook provided to enrollees, a health carrier shall include a clear and comprehensive description of its utilization review procedures, including the procedures for obtaining review of adverse determinations, and a statement of rights and responsibilities of enrollees with respect to those procedures.
2. A health carrier shall include a summary of its utilization review procedures in material intended for prospective enrollees.
3. A health carrier shall print on its membership cards a toll-free telephone number to call for utilization review decisions.
(L. 1997 H.B. 335)