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Multi-state Health Plans

The Affordable Care Act requires every health care exchange to offer at least two multi-state plans – one from a non-profit, and one which does not cover abortion (except as permitted by federal law). Plans are to be overseen by the Office of Personnel Management.

Utilization Review (UR)

Refers to the evaluation of the efficiency and need of health care services, including procedures and facilities, according to established criteria of the provisions of…