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Idaho Code Ann. § 41-3930, Utilization Management Program Requirements

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Establishes requirements for utilization management programs conducted by Managed Care Organizations (MCOs) or their contractors. Requires MCO members to authorize the release of their medical information to the MCO upon their enrollment. Requires MCOs to establish procedures for maintaining the confidentiality of patient health records. Permits MCOs to record phone conversations in which they request patient information if such recording is otherwise permitted by federal and state law and the other party receives notice that they are being recorded. Permits the recorded party to request and obtain access to the recording if the conversation is relevant to a formal grievance. Prohibits MCOs from requiring prior authorization for emergency services.


Current as of March 2020