Tenn. Comp. R. & Regs. 0800-02-06-.05 - MANDATORY UTILIZATION REVIEW

(1) If the employer as defined in 0800-02-06-.01 disagrees with the Authorized Treating Physician about the medical necessity of a recommended treatment, then the employer must participate in Utilization Review as defined in 0800-02-06-.01.

(2) Utilization review is required to be performed pursuant to the requirements of this Chapter whenever it is mandated by T.C.A. § 50-6-124 or the Bureau's Rules for Medical Payment, Medical Fee Schedule, or In-Patient Hospital Fee Schedule rules contained in Chapters 0800-02-17, 0800-02-18, and 0800-02-19, respectively.

Notes

Tenn. Comp. R. & Regs. 0800-02-06-.05

Original rule filed March 5, 1993; effective April 19, 1993. Amendment filed October 12, 2007; withdrawn December 12, 2007. Repeal and new rule filed August 14, 2009; effective November 12, 2009. Amendments filed October 31, 2016; effective 1/29/2017.

Authority: T.C.A. §§ 50-6-102, 50-6-124, 50-6-126, and 50-6-233.