Title: 17B, INSURANCE
Chapter 30: Liability of plaintiff upon discontinuance without leave
Section: 17B:30-55.16: Statistics available regarding prior authorization approvals, denials, website.
17. A payer shall make statistics available regarding prior authorization approvals and denials on its Internet website in a readily accessible format, as determined by the commissioner. Payers shall include categories for: a. health care provider specialty; b. medication or diagnostic tests and procedures; c. indication offered; d. reason for denial; e. whether prior authorization determinations were: (1) appealed; or (2) approved or denied on appeal; f. the time between submission of prior authorization requests and the determination; g. the average median time elapsed between a request for clinical records from the requesting health care provider and receipt of adequate clinical records to complete the prior authorization; and h. the number of appeals generated for cases denied in which there was inadequate or no prior clinical information. L.2023, c.296, s.17.
Added to Rutgers Database: 2024-06-14 13:51:18