Title: 17B, INSURANCE
Chapter 30: Liability of plaintiff upon discontinuance without leave
Section: 17B:30-55.6: Carrier, respond, prior authorization requests, medication coverage submitted, NCPDP SCRIPT Standard for ePA transactions.
7. a. A carrier shall respond to prior authorization requests for medication coverage submitted using the NCPDP SCRIPT Standard for ePA (electronic prior authorization) transactions, under the pharmacy benefit part of a health benefits plan, within 24 hours for urgent requests and 72 hours for non-urgent requests after obtaining all necessary information to make the approval or adverse determination. b. Beginning January 1, 2027, a carrier shall only accept and respond to prior authorization requests for medication coverage, under the pharmacy benefit part of a health benefits plan submitted through a secure electronic transmission using the NCPDP SCRIPT Standard for ePA transactions. L.2023, c.296, s.7.
Added to Rutgers Database: 2024-06-14 13:50:47