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The term utilization review includes decisions to certify or authorize health care services, adverse decisions, and grievance decisions. B. Scope of utilization review being requested in this State (Application items 5 through 16). Citation. Description.Utilization review licenses and certificates are typically issued for organizations conducting either medical or workers' compensation reviews. Utilization review organizations must typically obtain a certification or license before performing reviews. Affidavit of Compliance. Please check type of application: Initial Renewal. 1. A. The MCHIP licensee shall have a utilization review and management process that complies with the requirements of §§ 32.1-137. This application should be used for application for license as a utilization review organization pursuant to La. R.S. 94-2395. Direct all communication to:. A letter of good standing from the Texas Comptroller of Public Accounts.