However, it is not practical to apply for a medical license in all states, as would be required of physicians working for national managed care organizations. And most states still make a legal distinction between utilization review and the practice of medicine. In Louisiana, for example, the practice of medicine is defined in the Professions and Occupations Code as "being engaged in the business of, or the actual engagement in diagnosing, treating, curing, or relieving of any bodily or mental disease." According to the federal Utilization Review Act, utilization review is a process for determining "necessity and appropriateness in the allocation of health care resources and services." Yet Louisiana is one of numerous states in which medical boards have sought and won jurisdiction over medical directors of insurance companies.