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PDFWAC 296-20-024

Utilization management.

The department, as a trustee of the medical aid fund, has a duty to supervise the provision of proper and necessary medical care that is delivered promptly, efficiently, and economically. Toward this end, the department will institute programs of utilization management. These programs are designed to monitor and control the proper and necessary use and cost of, health care services. These programs include, but are not limited to, managed care contracting, prior authorization for services, and alternative reimbursement systems.
[Statutory Authority: RCW 51.04.020(4) and 51.04.030. WSR 90-04-057, § 296-20-024, filed 2/2/90, effective 3/5/90; WSR 87-24-050 (Order 87-23), § 296-20-024, filed 11/30/87, effective 1/1/88.]
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