In a UR department, is it permissible for a nurse to approve or deny requests?

• A. Always permissible
• B. Never permissible
• C. Only a licensed physician may modify, delay, or deny requests for medical treatment
• D. Ok if the nurse has met CE requirements

Answer: (C)

In utilization review, decisions to modify, delay, or deny medical treatment require clinical judgment that sits within a physician’s licensed scope of practice. A nurse can gather information, apply criteria, communicate with the team, and implement decisions once a physician has approved them, but the authority to unilaterally approve or deny treatment rests with a licensed physician. Continuing education credits do not change the scope of practice, and “always” or “never” permissibility isn’t accurate because it overlooks the collaborative, supervised nature of UR work.