| 26.1-36.12-01 |
Definitions
|
| 26.1-36.12-02 |
Disclosure and review of prior authorization requirements
|
| 26.1-36.12-03 |
Personnel qualified to make adverse determinations
|
| 26.1-36.12-04 |
Personnel qualified to review appeals
|
| 26.1-36.12-05 |
Prior authorization ‑ Nonurgent circumstances
|
| 26.1-36.12-06 |
Prior authorization - Urgent health care services
|
| 26.1-36.12-07 |
Prior authorization - Emergency medical condition
|
| 26.1-36.12-08 |
No prior authorization for medication-assisted treatment
|
| 26.1-36.12-09 |
Retrospective denial
|
| 26.1-36.12-10 |
Length of prior authorization
|
| 26.1-36.12-11 |
Chronic or long-term care conditions
|
| 26.1-36.12-12 |
Continuity of care for enrollees
|
| 26.1-36.12-13 |
Failure to comply - Services deemed authorized
|
| 26.1-36.12-14 |
Procedures for appeals of adverse determinations
|
| 26.1-36.12-15 |
Effect of change in prior authorization clinical criteria
|
| 26.1-36.12-16 |
Notification to claims administrator
|
| 26.1-36.12-17 |
Annual report to insurance commissioner
|
