(a) Personnel employed by or under contract with a utilization review agent to perform
utilization review must be appropriately trained and qualified and meet the requirements of this chapter and other applicable law, including applicable
(b) Personnel, other than a physician licensed to practice medicine, who obtain oral or written information directly from a patient's physician or other
health care provider regarding the patient's specific medical condition, diagnosis,
or treatment options or protocols must be a nurse, physician assistant, or other health
care provider qualified to provide the requested service.
(c) This section may not be interpreted to require personnel who perform clerical
or administrative tasks to have the qualifications prescribed by this section.
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