As used in this chapter, "clinical criteria" means:

1. (1) written policies;
2. (2) written screen procedures;
3. (3) drug formularies or lists of covered drugs;
4. (4) determination rules;
5. (5) determination abstracts;
6. (6) clinical protocols;
7. (7) practice guidelines;
8. (8) medical protocols; and

9. (9) any other criteria or rationale;

   used by the utilization review entity to determine the medical necessity of a health care service.

As added by P.L.144-2025, SEC.6.