10A NCAC 22F .0502. PEER REVIEW ESTABLISHED

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(a) The Division will establish Peer Review Boards, charged with the responsibility to evaluate the quality, appropriateness and necessity of care and services provided to Medicaid recipients.

(b) The Peer Review Boards will provide the means by which the Division may mediate and resolve medical issues arising from utilization reviews, program integrity investigations, and prior approvals.

History Note: Authority G.S. 108A‑25(b); 42 C.F.R. Part 455; 42 C.F.R. Part 456;

Eff. April 15, 1977;

Readopted Eff. October 31, 1977;

Amended Eff. May 1, 1984.

                    
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