TITLE 23
Health and Safety

CHAPTER 23-17.12
Health Care Services – Utilization Review Act

SECTION 23-17.12-8.1


§ 23-17.12-8.1 Variance of statutory requirements.

(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 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.

History of Section.
(P.L. 2006, ch. 218, § 1; P.L. 2008, ch. 304, § 1; P.L. 2008, ch. 424, § 1; P.L. 2010, ch. 190, § 1.)