UTILIZATION REVIEW (UR) – means the use of a set of formal techniques designed to monitor the use of, or evaluate the medical necessity, appropriateness, efficacy, or efficiency of, health care services, health care procedures or health care settings. Such techniques may include the monitoring of or evaluation of (A) health care services performed or provided in an outpatient setting, (B) the formal process for determining, prior to discharge from a facility, the coordination and management of the care that a patient receives following discharge from a facility, (C) opportunities or requirements to obtain a clinical evaluation by a health care professional other than the one originally making a recommendation for a proposed health care service, (D) coordinated sets of activities conducted for individual patient management of serious, complicated, protracted or other health conditions, or (E) prospective review, concurrent review, retrospective review or certification.
CGS §38a-591a through §38a-591n and Insurance Department Regulations §38a-591-1 through §38a-591-11 – see Laws and Regulations
No pro-rating, non-refundable application fee.
One (1) year. Renewal Applications are due each October 1st for a renewal effective January 31st. The NIPR System is not available for renewal September 1st.
How to Apply:
How to Renew:
How to Amend Lines of Authority:
How to Reinstate a License:
How to change License information: (ie.: demographics)
Material changes to policies/letters which must be reviewed:
Submit the revised redlined policies or letters by attaching in the NIPR warehouse for review. Submit an email to LHCompliance@ct.gov to advise that a material change has been added on the NIPR system in the NIPR warehouse.
Print a copy of the license:
Initial Education Requirements:
Waivers due to Designations:
Renewal Continuing Education (CE) Requirements:
Cancel the license: