Current through L. 2024, ch. 259
Section 36-2947 - Program contractors; additional responsibilitiesA. Program contractors shall establish and submit to the director for the director's approval utilization control systems comprised of prior authorization, concurrent review and retrospective review of services.B. If a member is no longer eligible for the system, the program contractor and the department shall notify the administration in accordance with rules adopted pursuant to section 36-2932, subsection G. If that member may be eligible for services under article 1 of this chapter, the program contractor shall refer the person to the administration and arrange for the transfer of records to the appropriate provider as defined in section 36-2901 on notice by the administration.