N.Y. Comp. Codes R. & Regs. tit. 14 § 514.4

Current through Register Vol. 46, No. 45, November 2, 2024

Section 514.4 - Definitions

For purposes of this Part:

(a)Clinical Review Criteria means the written screening policies, procedures, clinical protocols, practice guidelines, level of care tools, and programs used by a Utilization Review Agent to determine the medical necessity and appropriateness of a proposed health care service for the treatment of a Mental Health Condition.

(b)Office means the New York State Office of Mental Health.

(c)Mental Health Condition shall have the same meaning as such term is provided in sections 3216, 3221, and 4303 of the Insurance Law.

(d)Utilization Review shall have the same meaning as such term is provided in section 4900 of the Public Health Law or section 4900 of the Insurance Law, as applicable.

(e)Utilization Review Agent shall have the same meaning as such term is provided in section 4900 of the Public Health Law or section 4900 of the Insurance Law, as applicable.

N.Y. Comp. Codes R. & Regs. Tit. 14 § 514.4

Adopted New York State Register May 15, 2024/Volume XLVI, Issue 20, eff. 5/15/2024