IC 27-1-37.5-1.8: "Clinical criteria"

Sec. 1.8. As used in this chapter, "clinical criteria" means:

(1) written policies;

(2) written screen procedures;

(3) drug formularies or lists of covered drugs;

(4) determination rules;

(5) determination abstracts;

(6) clinical protocols;

(7) practice guidelines;

(8) medical protocols; and

(9) any other criteria or rationale;

used by the utilization review entity to determine the medical necessity of a health care service.