§ 27-8-17-8

(a) As used in this chapter, 'utilization review determination' means the rendering of a decision based on utilization review that denies or affirms either of the following:(1) The necessity or appropriateness of the allocation of resources.(2) The provision or proposed provision of health care services to a covered individual.(b) The term does not include the identification of alternative, optional medical care that:(1) requires the approval of the covered individual; and(2) does not affect coverage or benefits if rejected by the covered individual.As added by P.L.128-1992, SEC.1.