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New Jersey Statutes, Title: 17B, INSURANCE
Chapter 30: Declaration of purpose
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.
This section added to the Rutgers Database: 2024-06-14 13:51:18.
Older versions of 17B:30-55.16 (if available):
Court decisions that cite this statute: CLICK HERE.