25 Technical advisories on UR system standards; UR denial decision requirements; time frames for UR; communicating the UR decision
Technical Advisories on UR System Standards; UR Denial Decision Requirements; Time Frames for UR; Communicating the UR Decision [35 Pa.B. 77] Under 28 Pa. Code § 9.603 (relating to technical advisories), the Department of Health (Department), Bureau of Managed Care, is issuing technical advisories on Department's interpretation of 28 Pa. Code § 9.752(f) (relating to UR system standards) requiring a UR decision to include a contractual basis and clinical reasons for denial and 28 Pa. Code § 9.753 (relating to time frames for UR) communicating the UR decision.
Copies of the technical advisories may be obtained by contacting Stacy Mitchell, Director, Bureau of Managed Care, Department of Health, Room 912, Health and Welfare Building, P. O. Box 90, Harrisburg, PA 17108-0090, (717) 787-5193 or for speech and/or hearing impaired persons, V/TT (717) 783-6154 or the Pennsylvania AT&T Relay Service at (800) 654-5984 (TT).
Persons with a disability who require an alternative format of this notice (for example, large print, audiotape, Braille) should contact Stacy Mitchell at the address or telephone number as previously indicated.
CALVIN B. JOHNSON, M.D., M.P.H.,
Secretary[Pa.B. Doc. No. 05-25. Filed for public inspection December 30, 2004, 9:00 a.m.]
