Chapter 424

2008 -- S 2866

Enacted 07/08/08

A N A C T

RELATING TO HEALTH AND SAFETY - HEALTH CARE SERVICES UTILIZATION REVIEW ACT

Introduced By: Senator Hanna M. Gallo

Date Introduced: March 13, 2008

It is enacted by the General Assembly as follows:

     SECTION 1. Section 23-17.12-8.1 of the General Laws in Chapter 23-17.12 entitled

"Health Care Services - Utilization Review Act" is hereby amended to read as follows:

23-17.12-8.1. Variance of statutory requirements. [Repealed effective July 1, 2008.] -

- (a) The department is authorized to issue a statutory variance from one or more of the specific

requirements of this chapter to a review agent where it determines that such variance is necessary

to permit the review agent to evaluate and address practitioner billing and practice patterns when

the review agent believes in good faith that such patterns evidence the existence of fraud or

abuse. Any variance issued by the department pursuant to this section shall be limited in

application to those services billed directly by the practitioner. Prior to issuing a statutory

variance the department shall provide notice and a public hearing to ensure necessary patient and

health care provider protections in the process. Statutory variances shall be issued for a period not

to exceed one year and may be subject to such terms and conditions deemed necessary by the

department.

      (b) On or before January 15th, 2008 of each year, the department shall issue a report to

the general assembly summarizing any review agent activity as a result of a waiver granted under

the provisions of this section.

     SECTION 2. The date for repeal of this section is hereby extended to July 1, 2011.

     SECTION 3. This act shall take effect upon passage.

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LC02299

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