This chapter establishes standards and criteria for the structure and operation of utilization review and benefit determination processes carried out by health insurance organizations or issuers. Its purpose is to facilitate ongoing assessment and management of healthcare services provided to covered persons or enrollees.\nHistory —Aug. 29, 2011, No. 194, added as § 24.020 on Aug. 23, 2012, No. 203, § 5, eff. 90 days after Aug. 23, 2011.
Puerto Rico Legal Code