IC 27-8-17-8: "Utilization review determination" defined

Sec. 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.