Rhode Island  Rhode Island UM – 3.4.19 I.  Scope and Applicability A.  Who is subject to the state’s utilization management regulations? Review agents conducting utilization review in the state of Rhode Island. HMOs? Yes. Insurers? Yes. Utilization review organizations? Yes. ACOs? Yes, if the ACO is conducting utilization review. PPOs? Yes. Third party administrators? Yes. […]

To access this content, please login or click here to subscribe