397.98 Children’s substance abuse services; utilization management.—
(1) Utilization management shall be an integral part of each Children’s Network of Care Demonstration Model as described under s. 397.97. The utilization management process shall include procedures for analyzing the allocation and use of resources by the purchasing agent. Such procedures shall include:
(a) Monitoring the appropriateness of admissions to residential services or other levels of care as determined by the department.
(b) Monitoring the duration of care.
(c) Developing profiles of network providers which describe their patterns of delivering care.
(d) Authorizing care for high-cost services.
(2) The procedures shall be established by the purchasing agent in consultation with the department and are subject to approval by the secretary of the department. The implementation of utilization management within the demonstration models shall be contingent upon the availability of funds.
History.—s. 14, ch. 99-396.
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