Missouri Revised Statutes

Chapter 376
Life, Health and Accident Insurance
Section 376.1372

August 28, 2013


Certification and member handbook to include utilization review procedures.

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)


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