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MA DIA Publish Bulletin On Where UR's May Be Conducted

26 Mar, 2009 WorkersCompensation.com

                               
Boston, MA (CompNewsNetwork) - The Office of Health Policy (OHP) is issuing this informational bulletin to clarify an issue regarding the location/site where utilization reviews may be conducted.

The Utilization Review Application specifically requests the applicant to identify the "Location/Site where UR is Conducted".  The OHP staff inspects the proposed site as part of the application process.  If all criteria are met and the UR agent signs an “Affidavit of Compliance”, the UR agent is approved to conduct the review at the site identified in the application.  The UR agent agrees to notify the OHP of any material changes with respect to information provided in the application. 

All initial reviews must be conducted at the approved business site.  UR agent employees/independent contractors are not allowed to conduct initial reviews from a home environment.  If the UR agent chooses to conduct reviews at another site, a separate application must be submitted and a site inspection will take place.  Failure to adhere to policies and procedures may result in a suspension or revocation of the agent's approval to conduct utilization review.

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