1. (a) An insurer shall maintain, procure, and provide documentation, including contracts and written policies and procedures, and any other information requested by the Department, to demonstrate that the insurer, and any specialized behavioral health insurer, third-party administrator, contracting provider, or other entity that performs utilization review or utilization management functions on its behalf, is applying the most recent version of treatment criteria developed by a relevant nonprofit professional association pursuant to Insurance Code sections 10144.5 and 10144.52, and this article.
2. (b) An insurer shall preserve the books and records required under this article for the current year and the four preceding years in an easily accessible location at the headquarters office of the insurer and as required under Insurance Code sections 733 and 734, and Section 2695.3 of Title 10 of the California Code of Regulations.

Note: Authority cited: Sections 10144.5, 10144.52 and 10144.57, Insurance Code. Reference: Sections 730, 733, 734, 790.04, 10144.5, 10144.52, 10144.57, 12921, 12924 and 12926, Insurance Code.

History

1. New section filed 6-26-2025; operative 6-26-2025 pursuant to Government Code section 11343.4(b)(3) (Register 2025, No. 26).