To ensure that inmates receive only medical services that are authorized through its utilization management process, the Receiver's Office should develop processes by August 31, 2014, such that a procedure that may result in sterilization is not scheduled unless the procedure is approved at the necessary level of the utilization management process.
Proposed Action Plan:
Create additional InterQual custom criteria to ensure that a procedure that may result in sterilization is not scheduled without proper approval.
InterQual custom criteria were created. Notification within each criteria subset that requires secondary, Institution Utilization Management Committee and Headquarters Utilization Management Committee reviews are established.
Agency responses received are posted verbatim.